Hydrocodone Extended-Release (ER) CAPSULES:
The 50 mg capsules, a single dose greater than 40 mg, or a total daily dose greater than 80 mg are reserved for opioid tolerant individuals.
CONVERSION FROM OTHER ORAL OPIOIDS:
- Published potency tables can be used to estimate a patient’s 24-hour oral hydrocodone requirement; however, due to substantial inter-patient variability, it is best to underestimate a patient’s 24-hour requirement and provide rescue medication as the dose is titrated.
- Alternatively, the following conversion factors (CF) may be used to convert selected oral opioids to the hydrocodone extended-release capsule: Hydrocodone, CF=1; Oxycodone, CF=1; Methadone, CF= 1, Oxymorphone, CF=2; Hydromorphone, CF=2.67; Morphine, CF=0.67; Codeine, CF=0.1.
- These CFs cannot be used to convert from hydrocodone extended-release to the selected oral opioid as doing so will result in overestimation of the oral opioid dose and may result in fatal respiratory depression.
- Example: Sum the total daily dose of prior oral opioid; multiply that sum by the CF to obtain 24-hour oral hydrocodone requirement; divide 24-hour requirement by 2 (round down, if necessary ) and give 1 dose orally every 12 hours.
