- For the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
AND
AND
Conversion Factors to Zohydro ER (not equianalgesic doses) | ||
Prior Oral Opioid | Oral Dose (mg) | Approximate Oral Conversion Factor |
Hydrocodone | 10 | 1 |
Oxycodone | 10 | 1 |
Methadone | 10 | 1 |
Oxymorphone | 5 | 2 |
Hydromorphone | 3.75 | 2.67 |
Morphine | 15 | 0.67 |
Codeine | 100 | 0.10 |
Conversion Factors to Hysingla ER (not equianalgesic doses) | ||
Prior Oral Opioid | Oral Dose (mg) | Approximate Oral Conversion Factor |
Codeine | 133 | 0.15 |
Hydromorphone | 5 | 4 |
Methadone | 13.3 | 1.5 |
Morphine | 40 | 0.5 |
Oxycodone | 20 | 1 |
Oxymorphone | 10 | 2 |
Tramadol | 200 | 0.1 |
Oxycodone Hydrochloride | Oxycodone base (XTAMPZA ER) |
10 mg | 9 mg |
15 mg | 13.5 mg |
20 mg | 18 mg |
30 mg | 27 mg |
40 mg | 36 mg |
Drug | Dosing Regimen | Dose Limit/ Maximum Dose |
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morphine sulfate controlled-release tablet (MS ContinR) | Opioid naive patients: 15 mg PO Q12 hours Conversion to MS Contin: Dosing is individualized based on previous analgesic therapy. Administer at 1/2 the total daily requirement PO Q12 hours or 1/3 the total daily requirement PO Q8 hours | The 100 mg and 200 mg tablets are reserved only for opioid-tolerant individuals |
morphine sulfate sustained-release capsule | Opioid naive patients: 10 mg or 20 mg PO, may adjust dosage at 20 mg increment QOD Conversion to Kadian: Dosing is individualized based on previous analgesic therapy. Administer patient's total daily requirement PO Q24 hours or administer 1/2 the patient's total daily requirement PO Q12 hours. | Should not be given more frequently than Q12 hours |
fentanyl transdermal system (Duragesic) | Dosing is individualized based on previous analgesic therapy. | Reserved for opioid-tolerant individuals |
oxymorphone extended release | One tablet PO twice daily; | Patients who are not opioid-experienced being initiated on chronic around-the-clock |
morphine sulfate extended-release (AvinzaR) | Opioid naive patients: 30 mg PO Q24 hours, with dosage adjustments of not > 30 mg every 4 days Conversion to morphine sulfate extended-release: Dosing is individualized based on previous analgesic therapy Administer patient's total daily morphine requirement PO Q24 hours | 1600 mg/day Should not be given more frequently than Q24 hours |
OxyContin | One tablet PO twice daily; | One tablet PO twice daily; |
Drug | Dosing Regimen | Authorization Limit |
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Zohydro ERTM | For opioid-naive and opioid non-tolerant patients, initiate with 10 mg PO Q12 hours. Increase the dose of Zohydro ER in increments of 10 mg Q12 hours every 3 to 7 days as needed to achieve adequate analgesia. Individualize treatment; titrate to effective and tolerable dose. |
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Hysingla ER | For opioid-naive and opioid non-tolerant patients, initiate with 20 mg PO Q24 hours. Increase the dose of Hysingla ER in increments of 10 mg to 20 mg every 3 to 5 days as needed to achieve adequate analgesia. Individualize treatment; titrate to effective and tolerable dose. |
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Morphabond ER | For opioid-naive and opioid non-tolerant patients, initiate with 15 mg PO Q12 hours. |
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Xtampza ER | For opioid-naove and opioid non-tolerant patients, initiate with 9 mg PO Q12 hours. Limit daily dose to a maximum of 288 mg per day. |
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