Hydrocodone Extended-Release (ER) CAPSULES: Discontinue all other around the clock opioid drugs when initiating therapy with extended-release hydrocodone. If unacceptable side effects occur, the dose may be reduced.īreakthrough Pain: If the level of pain increases after dose stabilization, attempt to identify the source before increasing dose rescue medication with appropriate immediate-release analgesia may be helpfulĭOSE CONVERSIONS: Dose conversions should be done carefully and with close monitoring due to large patient variability in regards to opioid analgesic response. Dose adjustments to hydrocodone extended-release tablets should be made in 10 to 20 mg increments every 24 hours, every 3 to 5 days.Dose adjustments to hydrocodone extended-release capsules should be made in 10 mg increments every 12 hours, every 3 to 7 days.Individually titrate to a dose that provides adequate analgesia and minimizes adverse reactions. An opioid tolerant patient is one who has been receiving for 1-week or longer at least: oral morphine 60 mg/day, fentanyl transdermal patch 25 mcg per hour, oral oxycodone 30 mg/day, oral hydromorphone 8 mg/day, oral oxymorphone 25 mg/day, or an equianalgesic dose of another opioid.Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression monitor patients closely for respiratory depression, especially during the first 24 to 72 hours.The following dosing recommendations can only be considered suggested approaches to what is actually a series of clinical decisions over time each patient should be managed individually.Īs First Opioid Analgesic and For Patients who are NOT Opioid Tolerant:Įxtended-Release Capsules (Zohydro(R) ER): Initial dose: 10 mg orally every 12 hoursĮxtended-Release Tablets (Hysingla(R) ER): Initial dose: 20 mg orally every 24 hours
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