- Management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
OXYCONTINR (oxycodone controlled-release)
HNOR
PA for Qty >3/day for OxycontinR
AND
EQUIANALGESIC OPIOID CHART | ||
Analgesic | Parenteral IM, SC, IV (mg) | Oral/Rectal/Patch (mg) |
Morphine* | 10 | 30 |
Codeine | 130 | 200 |
Fentanyl | 0.1 to 0.2 | 25 mcg/hr (Patch) |
Hydromorphone | 1.5 | 7.5 |
Levorphanol | 2 | 4 |
Methadone | 10 | 20 |
Meperidine* | 75 | - |
Oxycodone | - | 20 |
Oxymorphone | 1 | 10 (Rectal) |
*Adjust dose in renal impairment
Estimated conversion factor for converting prior opioid doses to oral oxycodone2 (mg/day prior opioid x factor = mg/day oral oxycodone | ||
Prior Opioid | Oral | Parenteral |
Codeine | 0.15 | -- |
Hydrocodone | 0.9 | -- |
Hydromorphone | 4 | 20 |
Levorphanol | 7.55 | 15 |
Meperidine | 0.1 | 0.4 |
Methadone | 1.5 | 3 |
Morphine | 0.5 | 1.5 - 3 |
Oxycodone | 1 | -- |
Oxymorphone | 2 | -- |
Drug | Dosing Regimen | Dose Limit/ Maximum Dose |
---|---|---|
Morphine sulfate controlled-release tablet (MS ContinR) | Conversion to MS ContinR Dosing is individualized based on previous analgesic therapy. Administer at 1/2 the total daily requirement PO Q12H or 1/3 the total daily requirement PO Q8H | The 100 mg and 200 mg tablets are reserved only for opioid-tolerant individuals who |
Morphine sulfate sustained-release (KadianR) | Opioid naive patients 10 mg or 20 mg PO, may adjust dosage at 20 mg increment QOD Conversion to KadianR Dosing is individualized based on previous analgesic therapy. Administer patient's total daily requirement PO Q24H or Q12H at 1/2 the estimated total daily requirement | Should not be given more frequently than Q12H |
Fentanyl transdermal system (DuragesicR) | Dosing is individualized based on previous analgesic therapy. | Doses ≥ 25 mcg/hr patch are reserved for opioid-tolerant individuals. |
Morphine sulfate beads sustained-release (AvinzaR) | Opioid naive patients 30 mg PO Q24H, with dosage adjustments of not > 30 mg every 4 days Conversion to Avinza Dosing is individualized based on previous analgesic therapy. Administer patient's total daily morphine requirement PO Q24H. | 1600 mg/day |
Opana ERR (Extended-release oxymorphone crush resistant) Or Oxymorphone ER | One tablet PO BID; | Patients who are not opiod-experienced being initiated on chronic around-the-clock |
Drug | Dosing Regimen | Authorization Limit |
---|---|---|
OxycontinR (oxycodone controlled-release abuse deterrent) | One tablet PO BID; | 3 months initially for non-malignant pain. |