Usual Daily Dose of Oxynorm (Oxycodone)
The usual daily dose of Oxynorm (oxycodone) has no specific maximum limit and should be titrated based on pain control and tolerability, with a typical starting dose of 5-15 mg every 4-6 hours as needed for pain. 1
Initial Dosing Guidelines
- For opioid-naive patients, start with 5-15 mg every 4-6 hours as needed for pain 1
- For immediate-release formulations (Oxynorm), the initial dose is typically 10 mg twice daily 2
- For controlled-release formulations, start with 10 mg every 12 hours 3
- Lower starting doses should be considered for elderly patients or those with moderate hepatic or renal impairment 2
Titration and Maintenance
- Titrate the dose based on individual patient's response to their initial dose 1
- Most patients can be titrated to a stable dosage within 2 days of starting medication 4
- For chronic pain, administer on an around-the-clock basis rather than as needed 1
- The median total daily dose for chronic pain patients is approximately 80 mg 5
- In cancer pain studies, daily dosages typically range between 10-30 mg in the majority (89%) of cases 4
Dosing Frequency
- While the product is designed for twice-daily dosing, clinical practice shows that 67% of chronic pain patients may require more frequent dosing 5
- 93% of patients requiring more frequent dosing are prescribed oxycodone three times daily 5
- Patients maintained on every 12-hour dosing are twice as likely to need regularly scheduled short-acting opioids for breakthrough pain 5
Special Considerations
- For patients with liver cirrhosis, oxycodone should be initiated at lower doses due to decreased intrinsic hepatic clearance 3
- When converting from other opioids, consider the relative potency (oxycodone is approximately twice as potent as oral morphine) 3, 2
- No specific maximum daily dose has been established in clinical guidelines, as dosing is titrated based on pain control and tolerability 6
Common Side Effects and Management
- Most common side effects include nausea, constipation, and drowsiness 2
- Less common effects include vomiting, pruritus, and dizziness 2
- Side effects tend to decrease in intensity over time 2
- Oxycodone causes somewhat less nausea, hallucinations, and pruritus than morphine 2
Important Cautions
- Use the lowest effective dosage for the shortest duration consistent with treatment goals 1
- Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy 1
- When discontinuing, taper the dose gradually by 25-50% every 2-4 days to prevent withdrawal symptoms 1
- Avoid abrupt discontinuation in physically dependent patients 1
Oxycodone has shown efficacy in both nociceptive and neuropathic pain conditions, making it versatile for various pain syndromes 7. Its more predictable metabolism compared to morphine makes dose titration easier and potentially results in fewer side effects with long-term use 2.