From the FDA Drug Label
Initiate treatment with oxycodone hydrochloride tablets in a dosing range of 5 to 15 mg every 4 to 6 hours as needed for pain. The inpatient dose for pain is 5 to 15 mg every 4 to 6 hours as needed, and should be titrated based on the individual patient's response to their initial dose of oxycodone hydrochloride tablets 1.
- The dose should be adjusted to an acceptable level of analgesia, taking into account side effects experienced by the patient.
- Patients with chronic pain should have their dosage given on an around-the-clock basis to prevent the reoccurrence of pain.
- The dosage should be titrated to a dose that provides adequate analgesia and minimizes adverse reactions.
From the Research
Oxycodone for inpatient pain management should be initiated at a dose of 5-10 mg orally every 4-6 hours as needed for moderate to severe pain, with adjustments based on patient response and close monitoring for side effects, as supported by the most recent study 2.
Key Considerations
- For opioid-tolerant patients, higher initial doses may be required based on their current opioid regimen.
- Immediate-release formulations are preferred for acute pain and dose titration.
- The medication should be adjusted based on patient response, with close monitoring for respiratory depression, sedation, and other side effects, especially in elderly patients or those with renal or hepatic impairment.
- For these vulnerable populations, starting at lower doses (2.5-5 mg) is recommended.
- Breakthrough pain can be managed with additional doses, typically 50-100% of the regularly scheduled dose.
Multimodal Approach
- A multimodal approach combining oxycodone with non-opioid analgesics like acetaminophen or NSAIDs often provides better pain control with lower opioid requirements, as shown in a study comparing oxycodone/acetaminophen to acetaminophen alone for emergency department patients with musculoskeletal pain refractory to ibuprofen 2.
- For patients requiring prolonged therapy, consider transitioning to extended-release formulations once pain is stable.
Side Effects and Monitoring
- Regular assessment of pain control, side effects, and functional improvement is essential.
- Close monitoring for medication-related adverse events, such as respiratory depression, sedation, and nausea, is crucial, especially in patients who receive oxycodone/acetaminophen, as they are more likely to experience adverse events compared to those who receive acetaminophen alone 2.