Table 5: Oral Opioids for Acute Pain in Opioid-Naïve Adults
Available Oral Strengths
Medication
Moderate Pain Severe Pain
Clinical Considerations
Tramadol- acetaminophen • Ultracet
Tablets: • 37.5 mg/325 mg
1 to 2 tablets PO every six hours needed.
1 to 2 tablets PO every four hours as needed. 1 tablet PO every four to six hours as needed.
Only FDA-approved for five days or less of treatment of acute pain. Maximum dose: Eight tablets/24 hours. FDA-approved for short-term, acute, severe pain (<10 days). Do not exceed five tablets/day. Do not exceed four tablets/24 hours. The duration of therapy should not exceed seven days A decrease in incremental efficacy and an increase in adverse reactions with increasing doses. 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.
Ibuprofen-hydrocodone • lbudone
Tablets: • 5 mg/200 mg • 7.5 mg/200 mg • 10 mg/200 mg
• Reprexain • Vicoprofen • Xylon
Ibuprofen-oxycodone (Only available as generic)
Tablets: • 5 mg/400 mg
1 tablet PO every six hours.
Codeine (Only available as generic)
Tablets: • 15 mg • 30 mg • 60 mg
15 to 60 mg PO every four hours as needed.
Hydromorphone * • Dilaudid
Tablets: • 2 mg • 4 mg • 8 mg
2 to 4 mg PO every four to six hours as needed.
Oral Solution: • 5 mg/5 mL Tablets: • 15 mg • 30 mg Tablets: • 10 mg/0.5 mL • 10 mg/5 mL • 20 mg/5 mL • 20 mg/5 mL • 100 mg/5 mL
Morphine * (Only available as generic)
10 to 30 mg PO every four hours as needed.
Utilized only for severe, acute pain; not a first-line acute pain agent. Start with a low dose and titrate carefully.
Capsules: • 5 mg Tablets: • 5 mg • 7.5 mg • 10 mg • 15 mg • 20 mg • 30 mg
Oxycodone * • Oxaydo • Roxicodone • Roxybond
5 to 15 mg PO every four to six hours.
Utilized only for severe, acute pain; not a first-line acute pain agent. Start with low a dose and titrate carefully.
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 four to six 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.
Healthcare Consideration: Assessment of acute or chronic pain should be multidimensional. Consideration should be given to several domains, including the physiological features of pain and its contributing factors, with physicians and other clinicians assessing patients for function, quality of life, mental health, and emotional health. In addition to a complete medical and medication history typically obtained at an office visit, document pain intensity, location, duration, and factors that aggravate or alleviate pain (AAFP, 2021).
EliteLearning.com/ Dental
Book Code: DFL3024
Page 23
Powered by FlippingBook