Your activity: 4 p.v.
< Back

Immediate-release oral opioids for chronic pain in adults*[1,2]

Immediate-release oral opioids for chronic pain in adults*[1,2]
Immediate-release preparation Starting dose for opioid-naïve adult Half-life
Hydromorphone

2 to 4 mg (tablets or oral solution) orally every 4 to 6 hours as needed

 2 to 3 hours
Morphine

10 to 30 mg orally every 4 hours as needed

 2 to 3 hours
Oxycodone 5 to 10 mg mg orally every 4 to 6  hours as needed 2 to 3 hours
Oxymorphone 2.5 to 5 mg orally every 4 to 6 hours as needed 7 to 9 hours
Tapentadol 50 mg orally every six hours as needed 4 hours
Tramadol 25 to 50 mg orally every 6 hours as needed 6 to 9 hours (includes active metabolite)
* Doses should be lowered and dosing intervals extended for older patients, and for patients with hepatic or renal dysfunction. Doses may also require adjustment for patients with known pharmacogenetic differences in opioid metabolism, and for patients who are receiving medications that inhibit or induce cytochrome P450 enzymes.
¶ The lowest strength immediate-release morphine oral tablet available in the United States is 15 mg. Oral liquids are available and may be useful for prescribing oral morphine doses less than 7.5 mg.
Data from:
  1. American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009; 57:1331.
  2. Lexicomp Online. Copyright © 1978-2023 Lexicomp, Inc. All Rights Reserved.
Graphic 108947 Version 15.0