Table 10: Oral Opioids for Acute Pain in Opioid-Naïve Adults Medication Available Oral Strengths Moderate Pain
(Continued)
Severe Pain Clinical Considerations
Ibuprofen-oxycodone (Only available as generic)
Tablets: 5 mg/400 mg
1 tablet PO every 6 hours
Do not exceed 4 tablets/24 hours. The duration of therapy should not exceed 7days. Increasing doses do not improve efficacy and results in increased adverse effects. Limit codeine to no more than 60 mg/dose. Do not exceed 360 mg codeine/24 hours. Metabolism of codeine to morphine (its active form) varies between patients; drug interactions may affect response. Used only for severe, acute pain, not as a first-line acute pain agent. Start with a low dose and titrate carefully. Utilized only for severe, acute pain; not a first-line acute pain agent. Start with a low dose and titrate carefully.
Codeine (Only available as generic)
Tablets: 15 mg, 30 mg, 60 mg
15 to 60 mg PO every 4 hours as needed
Hydromorphone * • Dilaudid
Tablets : 2 mg, 4 mg, 8 mg Oral solution: 5 mg/5 mL
2 to 4 mg PO every 4 to 6 hours as needed
Morphine* (Only available as generic)
Tablets : 15 mg, 30 mg Oral Solution: 10 mg/0.5 mL 10 mg/5 mL 20 mg/5 mL 20 mg/5 mL 100 mg/5 mL
10 to 30 mg PO every 4 hours as needed
Oxycodone* • Oxaydo • Roxicodone • Roxybond
Capsules: 5 mg Tablets: 5 mg
5 to 15 mg PO every 4 to 6 hours
Utilized only for severe, acute pain; not a first-line acute pain agent. Start with low a dose and titrate carefully.
7.5 mg 10 mg 15 mg 20 mg 30 mg Oral Solution: 5 mg/5 mL 20 mg/5 mL 100 mg/5 mL
Tramadol (Ultram)
Tablets: 50 mg
1 to 2 tablets PO every 4 to 6 hours as needed
Maximum dose (<75 years): 400 mg/day. Maximum dose (75 years and older): 300 mg/day.
*Note: Avoid extended-release formulations and long-acting opioids in acute pain. Assessment of adults for chronic opioid therapy A comprehensive assessment of the patient,
other conditions that could influence the decision to utilize opioid analgesics. 99 The assessment should include:
caregiver(s), and family member(s) is necessary to determine an appropriate chronic pain management regimen. The goal is to determine the nature of the pain and how the pain affects the function and quality of life, assess prior treatment approaches, and detect
● Nature and intensity of pain.
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Book Code: MDCO1025
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