Achieving balance between analgesia and tolerability with OxyContin®

Continually assess the maintenance of pain control, signs and symptoms of opioid withdrawal, and adverse reactions, as well as monitoring for the development of addiction, abuse, and misuse. Consider prescribing naloxone for the emergency treatment of opioid overdose.

  • Individually titrate OxyContin to a dosage that provides adequate analgesia and minimizes adverse reactions
  • Titrate every 1 to 2 days, as needed
    • Steady-state plasma concentrations are approximated in 1 day
  • Total daily dosage for adults usually can be increased by 25% to 50% of the current total daily dosage as clinical need dictates, while maintaining every-12-hour dosing

Once treatment is established, remain mindful of your patient's evolving needs

  • If the level of pain increases after dose stabilization, attempt to identify the source of increased pain before increasing the OxyContin dosage
  • Provide supplemental analgesics (e.g., IR opioid or non-opioid) or adjust the dosage of OxyContin as needed for breakthrough pain
  • If unacceptable opioid-related adverse reactions are observed, consider reducing the dosage

With titration and maintenance of OxyContin, there are additional dosing considerations to be aware of

  • Like all full opioid agonists, there is no ceiling effect to analgesia for oxycodone. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression
  • Both tolerance and physical dependence can develop during chronic opioid therapy
  • Frequent communication is important among the prescriber, other members of the healthcare team, the patient, and the caregiver/family during periods of changing analgesic requirements, including initial titration
  • During chronic therapy, periodically reassess the continued need for the use of opioid analgesics
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