Oxycodone Equivalent of Norco 10-325 Every 4 Hours
The equivalent dose of OxyContin (extended-release oxycodone) for Norco 10-325 taken every 4 hours (60 mg hydrocodone daily) would be approximately 40 mg daily, divided into two 20 mg doses taken every 12 hours.
Understanding Opioid Equivalence
- According to the CDC Clinical Practice Guideline (2022), hydrocodone has a conversion factor of 1.0, while oxycodone has a conversion factor of 1.5 when calculating morphine milligram equivalents (MME) 1.
- This means oxycodone is approximately 1.5 times more potent than hydrocodone on a milligram-to-milligram basis 1.
Calculation of Equivalent Dose
- Norco 10-325 contains 10 mg of hydrocodone and 325 mg of acetaminophen 1.
- When taken every 4 hours, this equals 6 doses per day, totaling 60 mg of hydrocodone daily 1.
- Using the 1:1.5 potency ratio (hydrocodone:oxycodone), 60 mg of hydrocodone would be equivalent to approximately 40 mg of oxycodone daily 1, 2.
OxyContin Dosing Considerations
- OxyContin is an extended-release formulation of oxycodone intended for twice-daily dosing 1.
- The 40 mg daily dose would typically be divided into two 20 mg doses taken every 12 hours 3.
- It's important to note that OxyContin (extended-release oxycodone) is indicated for chronic pain and should not be used for acute pain 1.
- Long-acting and extended-release opioids like OxyContin are for use in opioid-tolerant patients only and are not intended for use as an "as-needed" analgesic 1.
Important Clinical Considerations
- When converting between opioids, a conservative approach is advised due to inter-patient variability in opioid response 4.
- Starting with a lower dose than the calculated equivalent is safer to avoid potential overdose 4.
- Close monitoring for respiratory depression is essential, especially within the first 24-72 hours of initiating therapy 4.
- OxyContin tablets must be taken whole and must not be broken, chewed, or crushed as this could lead to rapid release and absorption of a potentially fatal dose 2.
Cautions and Contraindications
- Extended-release oxycodone products like OxyContin should only be used in patients who are already opioid-tolerant 1.
- For opioid-naïve patients requiring oxycodone, immediate-release formulations should be used initially at lower doses (5-15 mg every 4-6 hours) 4.
- The lowest effective dosage should be used for the shortest duration consistent with individual patient treatment goals 4.
- Elderly patients may require lower doses due to altered pharmacokinetics 2, 5.