What is the recommended tapering schedule for oxycodone (oxycondone hydrochloride) 30mg?

Oxycodone 30mg Tapering Protocol

For tapering oxycodone 30mg, a decrease of 10% of the original dose per week is recommended as a reasonable starting point, with individualization based on patient factors and withdrawal symptoms. 1

General Tapering Approach

• Begin with a 10% reduction of the original dose per week (3mg reduction per week for 30mg oxycodone) 1
• For patients who have been on opioids for longer durations (years), slower tapers of 10% per month may be better tolerated 1
• The FDA recommends tapering by 25% to 50% every 2 to 4 days for patients who no longer require therapy 2

Step-by-Step Tapering Schedule for Oxycodone 30mg

Standard Approach (10% weekly reduction):

• Week 1: Reduce to 27mg daily 1
• Week 2: Reduce to 24mg daily 1
• Week 3: Reduce to 21mg daily 1
• Week 4: Reduce to 18mg daily 1
• Week 5: Reduce to 15mg daily 1
• Week 6: Reduce to 12mg daily 1
• Week 7: Reduce to 9mg daily 1
• Week 8: Reduce to 6mg daily 1
• Week 9: Reduce to 3mg daily 1
• Week 10: Discontinue 1

Alternative Approach (for patients requiring faster tapering):

• Reduce by 20-50% per week until reaching the smallest available dose unit 1
• Once the smallest available dose is reached (typically 5mg for oxycodone), increase the interval between doses 1
• Opioids may be stopped when taken less frequently than once a day 1

Managing Withdrawal Symptoms

• Monitor for withdrawal symptoms including drug craving, anxiety, insomnia, abdominal pain, vomiting, diarrhea, diaphoresis, mydriasis, tremor, and tachycardia 1
• Consider α2-adrenergic agonists (clonidine, lofexidine, guanfacine, tizanidine) to reduce sympathetic activity and withdrawal symptoms 1
• Use symptomatic treatments such as NSAIDs or acetaminophen for muscle aches and pain 1

Special Considerations

• Tapers may need to be paused and restarted when the patient is ready 1
• Tapers often need to be slowed once patients reach low dosages 1
• Consider a taper successful as long as the patient is making progress 1
• More rapid tapers might be needed for patient safety in circumstances such as overdose 1
• Avoid ultrarapid detoxification under anesthesia as it is associated with substantial risks, including death 1

Common Pitfalls to Avoid

• Abrupt discontinuation in physically dependent patients can lead to severe withdrawal symptoms 2
• If withdrawal symptoms become severe, return to the previous dose level and taper more slowly 2
• Patients who are not taking opioids (including those diverting all obtained opioids) do not require tapers 1
• Discuss with patients the increased risk for overdose if they return abruptly to a previously prescribed higher dose 1

Monitoring During Tapering

• Collaborate with mental health providers and specialists as needed to optimize nonopioid pain management and provide psychosocial support 1
• Consider offering naloxone for overdose prevention in high-risk patients 1
• If a patient exhibits signs of opioid use disorder, arrange for appropriate treatment 1

The Mayo Clinic approach uses a gradual, structured taper over 3 weeks with completion rates above 90%, though this is typically in a supervised setting 1. For outpatient tapering, the slower approach described above is generally safer and better tolerated 1.