- Larger doses may be required during chronic therapy. ER capsules are NOT bioequivalent to ER tablets.
- PO (Adults ≥50 kg): Opioid-naive patients: 5–10 mg (immediate release [IR]) every 3–4 hr initially, as needed. Once optimal analgesia is obtained, patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as ER tablets every 12 hr.
- PO (Adults <50 kg ): Opioid-naive patients: 0.2 mg/kg (IR) every 3–4 hr initially, as needed. Once optimal analgesia is obtained, patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as ER tablets every 12 hr.
- PO (Children ≥11 yr): 0.05–0.15 mg/kg (IR) every 4–6 hr as needed, as immediate-release product. Once optimal analgesia is obtained, patients with chronic pain may be converted to an equivalent 24-hr dose given in 2 divided doses as ER tablets every 12 hr.
- Rect (Adults ): 10–40 mg 3–4 times daily initially, as needed.
Hepatic Impairment
- PO (Adults ): ↓initial dose by 50–66%.
