Oxycodone 簡介

嘉義長庚疼痛科

施明宏醫師嘉義長庚藥劑部

Cancer pain

Cancer pain

2013台灣癌症時鐘

513

51~62 60 46

61 29

23 45

Cancer pain management

1 2

3

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Cancer pain

Cancer pain

2013台灣癌症時鐘

513

51~62 60 46

61 29

23 45

Cancer pain management

1 2

3

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Cancer pain

2013台灣癌症時鐘

513

51~62 60 46

61 29

23 45

Cancer pain management

1 2

3

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

61 29

23 45

Cancer pain management

1 2

3

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Cancer pain management

1 2

3

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

1

Cancer pain management

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

2NSAID

Strong Opioid419lt755

Cancer pain management

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

3

Cancer pain management

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Opiodmechanism

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Opioid mechanism

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Opioid mechanism

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Opioid mechanism

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodone

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

單一成分 全面鎮痛

讓止痛單純化

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

中重度癌症疼痛止痛藥物

全球醫療廣泛使用超過80年1917~

OxyNormreg Capsule 速效劑型Immediate Release Q6h

OxyContinreg Tablet 長效劑型Controlled Release Q12h

OxyNormreg 5mg $145capOxyContinreg 10mg $40tab

OxyContinreg 20mg $76tab

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

bull 需要長期疼痛控制之中重度癌症疼痛病患

bull 需要長期疼痛控制之慢性中重度非癌症疼痛病患且曾經接受過類鴉片藥物而無法有效控制疼痛者

適應症

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

PK OxyNormreg OxyContinreg

Onset 15-30 mins 1hr

Tmax 15-2 hr 4-5 hr

Steady-

State24- 36 hr 24- 36 hr

T12 32 hr 45 hr

interval Q6h or PRN Q12h

血中濃度

Ref 1 Mandema Jw et al Br J Pharmacol 199642747-56 2 Data on file 3 OxyNormreg中文仿單

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

藥物名稱 Receptor

micro ƙ

中樞與周邊鎮痛 脊髓與周邊鎮痛

Oxycodone + +Morphine + -

Fentanyl + -

hydromorphone + -

Oxycodne

1 2015 NCCN guideline version 2

2 Rang HP et al Pharmacology 5th Edition London Churchill Livingstone 2003

3 Vanderah TW et al Delta and kappa opioid receptors as suitable drug targets for pain Clin J Pain 2010 Jan26 Suppl 10S10-5

Oxycodne

混合型癌症疼痛

Oxycodone

Other Opoids

Non-opoids

Garciacutea de Paredes ML et al First evidence of oncologic neuropathic pain prevalence after screening 8615 cancer patients Results of the On studyAnn Oncol 2011 Apr22(4)924-30

Oxycodne

OxyContinreg 10mg 1Q12h

=

OxyNormreg 5mg1Q6h

=中度疼痛

NRS 4- 6分

OxyNormreg 5mgPRN

+

NRS ≧ 4分或一日突發性疼痛≧ 3次1 長效藥物增量25- 502 突發性疼痛藥物 16 同成分長效藥物日劑量3 止痛劑量 no celling effect

1 OxyContinreg amp OxyNormreg 中文仿單

2 Auret K Pickstock S Pain management in palliative care-an update Aust Fam Physician 2006 35 (10)762-5

Oxycodne

1 Nuacutentildeez Olarte JM et al Oxycodone and the challenge of neuropathic cancer pain a review Oncology 2008 74 (suppl 1) 83- 90

2 Cheville A et al A randomized trial of controlled-release oxycodone during inpatient rehabilitation following unilateral total knee

arthroplasty J Bone Joint Surg Am 200183-A(4)572- 576

3 Markenson JA et al Treatment of persistent pain associated with osteoarthritis with controlled-release oxycodone tablets in a randomized

controlled clinical trial Clin J Pain 200521524- 535

Oxycodne

生物利用度60-87

CYP3A4

CYP2D6

Noroxycodone

Oxymorphone

Oxycodne

長效性藥物

Receptors口服生體

可用率藥效作用起始時間

穩定血中濃度

適用病人 CostdayBreakthrough

Pain (同成分藥物)μ κ

MST + - 20-40 1小時 1-2天嚴重及頑固性

疼痛

25元 day= Morphine

60mg

嗎啡針劑 嗎啡速效錠 嗎啡口服液

OxyContinreg + + 60-87 1 小時 1-15天

中重度癌痛中重度非癌痛

80元 day= Morphine

40mg

OxyNormreg 5mg145元 顆

15-30 mins onset

FentanylPatch

+ - - 12 小時 4- 6天慢性疼痛與頑固性疼痛

63元 day= Morphine

30mg

Fentanyl Buccal200μg 單片 275元

Hydromor-phone

+ - 22-26 6-8小時 第4天僅用於癌症

末期病患之嚴重疼痛

135元 day= Morphine

40mg無

Oxycodne

Day 0 Pain

score 784 Day 7 Pain

score 335

- 57- 723

Tessaro et al European Review Med Pharma Science 2010 14113-121

Oxycodne

Narabayashi M et al Advisory Committee for Oxycodone Study Opioid rotation from oral morphine to oral oxycodone in cancer patients with intolerable

adverse effects an open-label trial Jpn J Clin Oncol 200838296-304

Oxycodne

副作用 OR P值

眩暈 104 090

噁心 052 0009

嘔吐 061 012

困倦 119 062

瘙癢 113 082

便秘 055 001

厭食 070 067

排尿困難 145 055

Wang YM et al Exp Ther Med 2012 4(2) 249-254

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Oxycodne

長效性藥物

Receptors口服生體

可用率藥效作用起始時間

穩定血中濃度

適用病人 CostdayBreakthrough

Pain (同成分藥物)μ κ

MST + - 20-40 1小時 1-2天嚴重及頑固性

疼痛

25元 day= Morphine

60mg

嗎啡針劑 嗎啡速效錠 嗎啡口服液

OxyContinreg + + 60-87 1 小時 1-15天

中重度癌痛中重度非癌痛

80元 day= Morphine

40mg

OxyNormreg 5mg145元 顆

15-30 mins onset

FentanylPatch

+ - - 12 小時 4- 6天慢性疼痛與頑固性疼痛

63元 day= Morphine

30mg

Fentanyl Buccal200μg 單片 275元

Hydromor-phone

+ - 22-26 6-8小時 第4天僅用於癌症

末期病患之嚴重疼痛

135元 day= Morphine

40mg無

Oxycodne

Day 0 Pain

score 784 Day 7 Pain

score 335

- 57- 723

Tessaro et al European Review Med Pharma Science 2010 14113-121

Oxycodne

Narabayashi M et al Advisory Committee for Oxycodone Study Opioid rotation from oral morphine to oral oxycodone in cancer patients with intolerable

adverse effects an open-label trial Jpn J Clin Oncol 200838296-304

Oxycodne

副作用 OR P值

眩暈 104 090

噁心 052 0009

嘔吐 061 012

困倦 119 062

瘙癢 113 082

便秘 055 001

厭食 070 067

排尿困難 145 055

Wang YM et al Exp Ther Med 2012 4(2) 249-254

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Oxycodne

Day 0 Pain

score 784 Day 7 Pain

score 335

- 57- 723

Tessaro et al European Review Med Pharma Science 2010 14113-121

Oxycodne

Narabayashi M et al Advisory Committee for Oxycodone Study Opioid rotation from oral morphine to oral oxycodone in cancer patients with intolerable

adverse effects an open-label trial Jpn J Clin Oncol 200838296-304

Oxycodne

副作用 OR P值

眩暈 104 090

噁心 052 0009

嘔吐 061 012

困倦 119 062

瘙癢 113 082

便秘 055 001

厭食 070 067

排尿困難 145 055

Wang YM et al Exp Ther Med 2012 4(2) 249-254

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Oxycodne

Narabayashi M et al Advisory Committee for Oxycodone Study Opioid rotation from oral morphine to oral oxycodone in cancer patients with intolerable

adverse effects an open-label trial Jpn J Clin Oncol 200838296-304

Oxycodne

副作用 OR P值

眩暈 104 090

噁心 052 0009

嘔吐 061 012

困倦 119 062

瘙癢 113 082

便秘 055 001

厭食 070 067

排尿困難 145 055

Wang YM et al Exp Ther Med 2012 4(2) 249-254

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Oxycodne

副作用 OR P值

眩暈 104 090

噁心 052 0009

嘔吐 061 012

困倦 119 062

瘙癢 113 082

便秘 055 001

厭食 070 067

排尿困難 145 055

Wang YM et al Exp Ther Med 2012 4(2) 249-254

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

=

OxyContinreg 10mg 1Q12h

OxyNormreg 5mg1Q6h

=

PotencyMorphine Oxycodone

1 15~2

NRS 4- 6分

Oxycodne

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Le

ve

l o

f A

ctiva

tio

n

MOR-1

Variant 1

Drug 1

Drug 2

Receptor

MOR-1

Variant 2

MOR-1

Variant 3

MOR-1

Variant 4

MOR-1

Variant 5

MOR = mu opioid receptor

Adapted from Pasternak GW Trends Pharmacol Sci 20012267

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Essential Opioids (WHO)

bull Codeine

bull Morphine

bull Oxycodone

bull Hydromorphone

bull Methodone

bull Buprenorphine

Ref WHO Model List of Essential Medicines 18th list (April 2013

httpwwwwhointmedicinespublicationsessentialmedicines18th_EML_Final_web_8Jul13pdf

2013 WHO Essential Medicines in Palliative Care

Essential Opioids (IAHPC)

Oxycodone and hydromorphone mentioned as the two alternatives to morphine

bull Codeine

bull Fentanyl

bull Methadone

bull Morphine

bull Oxycodone

bull Tramadol

Opioid rotation

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

90

80

70

60

50

40

30

20

10

0

o

f pa

tie

nts

Prescription

1 (N=86)

Prescription

5 (N=7)

Prescription

2 (N=52)

Prescription

3 (N=30)

Prescription

4 (N=18)

Side effect

Ineffectiveness

Effective

Total effective

Quang-Cantagrel ND et al Anesth Analg 200090(4)933

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Opioid-induced Hyperalgesia

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Opioids Dosage Conversion

ios

Opioid Calculator

android

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Opioid rotation

Opioids of choice in frail elderly and renal failure

Hydromorphone

Oxycodone

Fentanyl

Methadone

Poppy

Poppy