What is the recommended Oxycodone dose and frequency?

From the Guidelines

The recommended Oxycodone dose and frequency is 5-15 mg every 4-6 hours as needed for acute pain management in opioid-naive patients.

Key Considerations

• The dose and frequency may vary depending on the individual patient's response to the medication and their medical history.
• It's essential to start with a low dose and titrate upwards to minimize the risk of adverse effects, such as respiratory depression.
• The conversion factor for Oxycodone is 1.5 when calculating the morphine milligram equivalent (MME) dose 1.
• For patients with moderate to severe pain, the starting dose of Oxycodone can be 20 mg without pretreatment, with a relative effectiveness of 1.5-2 compared to Morphine sulfate 1.
• In the emergency department, the recommended starting dose for Oxycodone is 5-15 mg every 4-6 hours as needed for acute pain management 1.

Important Notes

• Oxycodone should not be used for acute pain management in patients who are opioid-tolerant, as it may not provide adequate pain relief.
• Long-acting or extended-release Oxycodone products, such as OxyContin, are indicated for chronic pain management and should not be used for acute pain.
• When converting from one opioid to another, it's crucial to use a substantially lower dose than the calculated MME dose to avoid overdose due to incomplete cross-tolerance and individual variability in opioid pharmacokinetics 1.

From the FDA Drug Label

2 DOSAGE AND ADMINISTRATION

Dosage and Administation: 2. 1 Important Dosage and Administration Instructions Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals Initiate the dosing regimen for each patient individually, taking into account the patient's severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse 2. 2 Initial Dosage Use of Oxycodone Hydrochloride Tablets as the First Opioid Analgesic 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 recommended initial dose of Oxycodone is 5 to 15 mg every 4 to 6 hours as needed for pain. The dose should be titrated based on the individual patient's response to their initial dose. For patients with chronic pain, the dosage should be given on an around-the-clock basis to prevent the reoccurrence of pain. The goal is to find the lowest effective dosage that provides adequate analgesia and minimizes adverse reactions 2.

• Key considerations for determining the initial dose include:
  • Severity of pain
  • Patient response
  • Prior analgesic treatment experience
  • Risk factors for addiction, abuse, and misuse
• Titration should be done individually to achieve adequate analgesia and minimize adverse reactions.

From the Research

Recommended Oxycodone Dose and Frequency

The recommended dose and frequency of oxycodone vary depending on the patient's condition and the formulation of the medication.

• The mean daily dosage of oxycodone was approximately 40 mg, with a low incidence of intolerable typical opiate side effects 3.
• In one study, the maximum dose of oxycodone was 400 mg/day for cancer patients and 80 mg/day for patients with low back pain 4.
• The median dose of sustained-release oxycodone was 80 mg for patients prescribed twice daily dosing, 60 mg when prescribed 3 times daily, and 120 mg when 4 times daily 5.
• The initial dose of controlled-release oxycodone is 10 mg b.i.d. for new treatments, with no dose reduction needed in the elderly or in cases of moderate hepatic or renal failure 6.

Dosing Frequency

• Controlled-release oxycodone can be administered every 12 hours, with 33% of patients requiring twice daily dosing and 67% requiring greater than twice daily dosing 5.
• In one study, 91% of oxycodone CR-treated patients required dosing more frequently than that recommended by the product's manufacturer, with a mean daily number of doses of 3.0 7.
• Patients who received oxycodone CR required a mean of 2.9 rescue doses per day, indicating that many patients require more frequent dosing than recommended 7.