Recommended Oral Oxycodone Dosing for a 15-Year-Old (60kg)
For a 15-year-old patient weighing 60kg, the recommended initial oral oxycodone dose is 5-10mg every 4-6 hours as needed, with careful titration based on pain control and side effects.
Dosing Considerations for Adolescents
When prescribing oxycodone to adolescents, several important factors must be considered:
- Weight-based dosing: For a 60kg adolescent, adult dosing guidelines can generally be followed, but starting at the lower end of the dosing range is prudent
- Opioid naïvety: If the patient is opioid-naïve, start with 5mg every 4-6 hours
- Pharmacokinetics: Oxycodone has a half-life of 3-5 hours with oral bioavailability ranging from 60-87% 1
- Onset and duration: Immediate-release oxycodone takes effect within 1 hour and lasts approximately 3-4 hours 1
Dosing Algorithm
Initial dosing:
- Start with 5mg PO every 4-6 hours for moderate pain
- For severe pain, may start with 10mg PO every 4-6 hours
Titration:
- Assess pain control and side effects every 60 minutes after administration
- If pain control is inadequate after 24 hours, may increase dose by 25-50%
- Do not exceed 20mg per dose initially without specialist consultation
Maintenance dosing:
- Once stable pain control is achieved, consider conversion to controlled-release formulation
- For controlled-release formulation, divide total daily dose by 2 and administer every 12 hours
Formulation Options
- Immediate-release: Useful for initial titration and breakthrough pain
- Controlled-release: Once stable dosing is established, controlled-release formulations can be used every 12 hours 2
Side Effect Management
- Anticipate constipation: Initiate prophylactic bowel regimen with stimulant laxative
- Monitor for sedation: Especially during initial dosing and dose increases
- Nausea management: Consider antiemetics if needed
- Respiratory depression: Monitor closely, especially within first 24-72 hours of therapy
Important Considerations and Pitfalls
- Avoid rapid dose escalation: Increases risk of adverse effects without proportional increase in analgesia
- Monitor for signs of tolerance: May require dose adjustments over time
- Breakthrough pain: Provide immediate-release oxycodone at approximately 10% of total daily dose for breakthrough pain 3
- Avoid crushing or breaking controlled-release formulations: Must be taken whole to maintain extended-release properties 1
- Reassess regularly: Evaluate continued need for opioid therapy and possibility of dose reduction or discontinuation
Conversion Information
If switching from another opioid, use appropriate conversion factors:
- Oral morphine to oral oxycodone ratio is approximately 1.5-2:1 1
- For example, 15mg oral morphine ≈ 10mg oral oxycodone
Remember that oxycodone has no ceiling effect for analgesia, but higher doses increase the risk of adverse effects without necessarily providing proportional pain relief 3.