Opioid Analgesics for adults Class II

• titrate to individual response
• dose does not apply to patients with renal or hepatic insufficiency

• Morphine
  • Immediate release (MSIR): tab 15, 30 mg. Dose: 5-30 mg q2-6h
  • MS Contin, Oramorph SR: Tab: 15, 30, 60, 100 mg. Dose 15-120 mg q12
  • Roxanol SR: 30 mg. Dose 30 mg q8 prn
  • Usual parenteral dose: 5-10 mg q4-5h

• Hydromorphone (Dilaudid)
  • Tab: 2, 4, 8 mg. Dose: 2-6 mg po q3-4h
  • 3 mg rectal suppository
  • Usual parental dose: 1.5 mg q3-4h

• Levorphanol (Levo-Dromoran)
  • Oral: 4 mg q6-8h
  • Usual parental dose: 2 mg q6-8h

• Meperidine (Demerol)
  • Oral dose not recommended
  • Usual parenteral dose: 50-100 mg q3h, extreme caution if patient has renal failure, accumulation of active metabolite may cause CNS excitement & seizure

• Methadone (Dolophine)
  • Comes in 5, 10 mg
  • Oral: 5-20 mg q6-8h
  • Usual parenteral dose: 10 mg q6-8h

• Oxycodone
  • Roxicodone: soln: 5 mg/5ml, 20 mg/ml, tab 5 mg. Dose: 5-10 mg q3-4h
  • Oxycontin controlled release tab: 10, 20, 40,  80, 160 mg. Dose variable
  • Parenteral: not available

• Oxymorphone (Numorphan)
  • Oral: not available
  • Usual parenteral dose: 1 mg q3-4h

• OPIOID ANALGESIC EQUIVALENTS 
• Identification and Management of the Drug-Seeking Patient - AFP May 2000
• Non opiod analgesics
• Opiod analgesics class III & IV
• Muscle relaxants