Table 2.

Common opioid dosing

Medication	Usual Dosing Range	Other
Morphine	PO 5–30 mg every 4 h SR 15–30 mg every 12 h (may need to be every 8 h in some patients)	Drug of choice in severe pain, use with caution in renally compromised patients
Hydromorphone	PO 2–4 mg every 4–6 h	Use in severe pain
Codeine	PO 15–60 mg every 4–6 h	Use in mild to moderate pain
Hydrocodone	PO 5–10 mg every 4–6 h	Use in moderate/severe pain
Oxycodone	PO 5–15 mg every 4–6 h CR 10–20 mg every 12 h	Use in moderate/severe pain
Fentanyl	Transdermal 25 μg/h every 72 h Transmucosal, intranasal, and sublingual dosing based off of individual product	Do not use transdermal patch in acute pain Follow product-specific initiation and titration dosing recommendations
Methadone	PO 2.5–10 mg every 8–12 h	Effective in severe chronic pain Equianalgesic dose of methadone when compared with other opioids will decrease progressively the higher the previous opioid dose. Methadone prescribed for maintenance or detoxification treatment and must be dispensed under a Substance Abuse and Mental Health Services administration–certified opioid treatment program
Buprenorphine	Transdermal delivery systems 5, 7.5, 10, 15, 20 μg/h every 7 d Buccal film 75 μg every 12 h to 900 μg every 12 h	Second-line agent for moderate-to-severe pain May precipitate withdrawal in opiate-dependent patients Detailed manufacturer dosing conversion recommendations exist Buprenorphine products that contain naloxone (Suboxone) should be considered in patients with OUD). The prescribers of buprenorphine/naloxone products for OUD require a Drug Enforcement Agency waiver
Tramadol	PO 50–100 mg every 4–6 h ER PO 100 mg every 24 h	Maximum dose for nonextended release, 400 mg/24 h; maximum for extended release, 300 mg/24 h Decrease dose in patient with renal impairment and in the elderly

Abbreviations: CR, controlled release; ER, extended release; OUD, opioid use disorder; PO, oral; SR, sustained release.

Data from Herndon CM, Strickland JM, Ray JB. Pain Management. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 10e. McGraw-Hill; Accessed October 06, 2020.2020. https://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=146063604.