Dosing and Administration

The usual starting dose for opioid naïve patients or patients presenting with severe pain uncontrolled by weaker opioids is 10mg, 12-hourly. Some patients may benefit from a starting dose of 5mg to minimise the incidence of side effects. The dose should then be carefully titrated, as frequently as once a day if necessary, to achieve pain relief

Generally, the lowest effective dose for analgesia should be selected. Increasing severity of pain will require an increased dosage, using the different tablet strengths, either alone or in combination, to achieve pain relief. The correct dosage for any individual patient is that which controls the pain and is well tolerated for a full 12 hours. Patients should be titrated to pain relief unless unmanageable adverse drug reactions prevent this. If higher doses are necessary increases should be made in 25% – 50% increments. The need for escape medication more than twice a day indicates that the dosage of Oxeltra tablets should be increased.

For the majority of patients, the maximum dose is 200mg 12-hourly. However, a few patients may require higher doses. Doses in excess of 1000mg have been recorded.

Patients receiving oral morphine before Oxeltra therapy should have their daily dose based on the following ratio: 10mg of oral oxycodone is equivalent to 2 mg of oral morphine. It must be emphasised that this is a guide. Inter-patient variability requires that each patient is carefully titrated to the appropriate dose.