Table 11: Oral Opioids for Acute Pain in Opioid-Naïve Adults (Continued) Medication Available Oral Strengths Dosage
Clinical Considerations
Morphine, immediate release
Tablets: 15 mg 30 mg
Initiate: • 10 to 30 mg PO every 4 hours as needed
Commonly used for breakthrough pain in patients receiving around-the-clock morphine.
Oral solution: 10 mg/0.5 mL 10 mg/5 mL 20 mg/5 mL 20 mg/5 mL 100 mg/5mL
Morphine, extended-release tablets • Arymo ER
Tablets: 15 mg 30 mg 60 mg 100 mg 200 mg
Conversion from immediate-release morphine: • Calculate total daily morphine dose; give half every 12 hours or one-third every 8 hours every 1 to 2 days based on complete daily morphine requirements • Adjust dosage Conversion from immediate release morphine: • Calculate total daily morphine dose and give orally once daily • Adjust dosage every 1 to 2 days (Kadian) or 3 to 4 days (Avinza) based on total daily morphine requirements Initiate: • 5 to 15 mg PO every 4 to 5 hours.
Conversion ratios from other opioids to extended-release morphine formulations have not been defined. During treatment with extended-release formulations, immediate-release formulations may be required for breakthrough pain.
• Morphaond • MS Contin
Morphine, extended-release
Capsules: 10 mg 20 mg 30 mg 40 mg 60 mg 80 mg
Conversion ratios from other opioids to extended-release morphine formulations have not been defined. During treatment with extended-release formulations, immediate-release formulations may be required for breakthrough pain.
capsules • Avinza • Kadian
100 mg 200 mg
Oxycodone, immediate release • Oxaydo • Roxicodone, • Roxybond
Capsules: 5 mg Tablets : 5 mg
Commonly used for breakthrough pain in patients receiving around-the-clock oxycodone.
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
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Book Code: MDCO1025
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