Sustained-release oxycodone dosing survey of chronic pain patients

To determine the dosing of sustained-release oxycodone that is typically prescribed to achieve pain relief in a mixed group of chronic pain patients.

One hundred twenty-eight chronic pain patients prescribed stable doses of sustained-release oxycodone for at least 6 months were identified through chart review. Total daily dosing for both long- and short-acting opioids were recorded for each patient.

The prescribed frequency of dosing sustained-release oxycodone determined through clinical practice was twice daily for 33% of patients, with 67% requiring greater than twice daily dosing. Ninety-three percent of those using greater than twice daily dosing were prescribed sustained-release oxycodone 3 times daily. The median dose of sustained-release oxycodone was 80 mg for patients prescribed twice daily dosing, 60 mg when prescribed 3 times daily, and 120 mg when 4 times daily. Regularly scheduled, daily supplemental short-acting opioids were used by 47% of patients prescribed twice daily sustained-release oxycodone and 21% prescribed greater than twice daily dosing. The median total oxycodone-equivalent daily dosage (short- + long-acting opioids) was 80 mg for patients treated with either twice daily or greater than twice daily dosing.

In a mixed group of chronic pain patients referred to a university pain management clinic, sustained-release oxycodone was prescribed more often than twice daily (usually every 8 hours) in 67% of patients. Patients maintained on every-12-hour dosing were twice as likely to use regularly scheduled, daily, short-acting opioids to achieve pain relief.