Table 3: Opioid-Based Analgesics Used for Orofacial Pain Generic Name Levorphanol Meperidine
Methadone
Morphine
Brand name(s) and available strengths (mg)
Multiple Generics 2 mg tablets
Multiple Generics 50, 100 mg tablets; 10 mg/mL oral solution
Dolophine & Generics 5, 10, 40 mg tablets; 1 mg/mL, 2 mg/mL, and 10 mg/mL oral solution
Multiple Generics 15, 30 mg tablets; 2 mg/mL, 4 mg/mL and 20 mg/mL oral solutions MS Contin & Generics 15, 30, 60, 100, 200 mg extended-release (ER) tablets Kadian & Generics 10, 20, 30, 40, 50, 60, 70, 80, 100, 200 mg extended-release (ER) capsules 4 hours 8-24 hours for ER products
Duration of action Usual adult starting dosages
6-8 hours
3-4 hours
8-12 hours
2 mg q6-8h
50 mg q3-4h
2.5-10 mg q8-12h
10-30 mg q4h 15-30 mg q8-12h (MS Contin & Generics) 30 mg q24h (Kadian & Generics)
Notes
Accumulation may occur with chronic use. Primarily used to treat chronic pain.
Oral meperidine is not recommended for treatment of acute or chronic pain; toxic metabolite with long half-life causes CNS excitation and convulsions; tissue irritation occurs with parenteral use; use should be limited to ≤48 hours.
Accumulation may occur with chronic use.
Taking Kadian or multiphase ER capsules with alcohol can result in rapid release of morphine.
Generic Name Brand name(s) and available strengths (mg)
Oxycodone
Oxymorphine
Tapentadol
Tramadol
Multiple Generics 5 mg capsules; 5, 7.5, 10, 15, 20, 30 mg tablets; 1 mg/mL, 20 mg/mL oral solutions OxyContin 10, 15, 20, 30, 40, 60, 80 mg extended-release (ER) tablets Xtampza ER 9, 13.5, 18, 27, 36mg extended-release (ER) capsules 4-6 hours 12 hours (ER formulations) 5-15 mg q4-6h 10 mg q12h (ER Tablets) 1 9 mg q12h (ER Capsules) OxyContin and others have been reformulated to deter abuse of the drug by injection or snorting.
Opana & Generics 5, 10 mg tablets ER Generics
Nucynta 50, 75, 100mg tablets Nucynta ER 50, 100, 150, 200, 250mg ER tablets
Ultram & Generics 50 mg tablets Ultram ER & Generics 100, 200, 300 mg extended-release (ER) tablets ConZip & Multiphase Generics 100, 150, 200, 300 mg extended-release (ER) capsules
5, 7.5, 10, 15, 20, 30, 40 mg extended-release (ER) tablets
Duration of action Usual adult starting dosages
4-6 hours 12 hours (ER Tablets) 5-15 mg q4-6h 5 mg q12h (ER Tablets)
4-6 hours 12 hours (ER formulations)
4-6 hours 24 hours (ER Formulations)
50-100mg 4-6 hours 50mg bid (ER formulations)
50-100 mg q4-6h (Ultram & Generics) 100 mg once/d (ER Formulations) Maximum dose is 400 mg/d for immediate- release formulations and 300 mg/d for ER formulations.
Notes
No CYP drug interactions. Fewer GI adverse effects, but similar CNS effects compared to some other opioid agonists.
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