What oral oxycodone dose should replace a 5 mg/24‑hour oxycodone transdermal patch?

Oral Oxycodone Replacement for 5mg Transdermal Oxycodone Patch

There is no FDA-approved 5mg oxycodone transdermal patch available—oxycodone patches do not exist in clinical practice. You may be confusing this with fentanyl transdermal patches, which are the standard transdermal opioid formulation.

Critical Clarification

If you are asking about fentanyl transdermal patches, the conversion would be:

Fentanyl to Oral Oxycodone Conversion

Assuming you meant a fentanyl patch (not oxycodone):

• A 12 mcg/hour fentanyl patch (the lowest available dose, closest to what might be confused as "5mg") converts to approximately 30-45 mg oral morphine equivalents per day 1
• Using the CDC conversion factor of 1.5 for oxycodone 1, this equals approximately 20-30 mg oral oxycodone per day
• Recommended replacement: Oxycodone 5-10 mg every 6 hours (20-40 mg/day total) 2

Conversion Algorithm

1. Calculate morphine milligram equivalents (MME) from the fentanyl patch using the conversion factor of 2.4 1

   • Example: 12 mcg/hour fentanyl × 2.4 = 28.8 MME/day

2. Convert MME to oral oxycodone by dividing by 1.5 1

   • 28.8 MME ÷ 1.5 = approximately 19-20 mg oral oxycodone daily

3. Divide into scheduled doses every 4-6 hours for immediate-release formulations 2, 3

   • Oxycodone 5 mg every 6 hours = 20 mg/day

4. Provide rescue doses of 10-15% of total daily dose for breakthrough pain 2

Important Timing Considerations

• Remove the fentanyl patch and start oral oxycodone simultaneously 2
• Fentanyl has a long half-life with continued absorption for 12-24 hours after patch removal 2
• Monitor closely for the first 24 hours for both inadequate analgesia and opioid toxicity 2
• Consider reducing the initial oral oxycodone dose by 25-50% in the first 12 hours if the patient appears oversedated 2

Common Pitfalls to Avoid

• Do not assume 1:1 conversion—transdermal and oral formulations have different bioavailability 3
• Oxycodone has 60-87% oral bioavailability, making it more potent orally than many other opioids 3
• Avoid using transdermal fentanyl conversion ratios for oxycodone—they are different medications with distinct pharmacokinetics
• Patients with renal impairment require dose reduction as oxycodone metabolites accumulate 3
• Elderly patients may need lower starting doses despite similar pharmacokinetics 3

If You Actually Meant Oxycodone Formulation Switch

If switching from oral extended-release oxycodone to immediate-release:

• Use a 1:1 total daily dose conversion 3
• Divide the total daily dose into 4-6 administrations for immediate-release formulations 2
• Example: 20 mg extended-release twice daily (40 mg/day) → 10 mg immediate-release every 6 hours

Bottom line: Clarify whether you're dealing with fentanyl or oxycodone, as oxycodone transdermal patches do not exist in standard clinical practice.