Moderate to Severe Pain
- PO (Adults and Children ≥50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients: 2.5 mg every 8–12 hr.
- PO (Adults and Children <50 kg): 0.1 mg/kg/dose every 4 hr for 2–3 doses, then every 6–8 hr as needed; maximum: 10 mg/dose.
- PO IV (Neonates ): Initial 0.05–0.2 mg/kg/dose every 12–24 hr or 0.5 mg/kg/day divided every 8 hr; taper dose by 10–20% per wk over 1–1.5 mo.
- IV IM SC (Adults and Children ≥50 kg): 10 mg every 6–8 hr.
- IV IM SC (Adults and Children <50 kg): 0.1 mg/kg every 6–8 hr; maximum: 10 mg/dose.
Opioid Detoxification
- PO (Adults and Children ≥50 kg): 15–40 mg once daily or amount needed to prevent withdrawal. Dose may be ↓ every 1–2 days; maintenance dose is determined on an individual basis.
- PO (Adults and Children <50 kg): 0.05–0.1 mg/kg/dose every 6 hr; ↑ by 0.05 mg/kg/dose until withdrawal symptoms controlled; after 1–2 days, lengthen dosing interval to every 12–24 hr; taper by ↓ dose by 0.05 mg/kg/day.
- IV IM SC (Adults and Children ≥50 kg): 15–40 mg once daily or amount needed to prevent withdrawal. May ↓ dose every 1–2 days; maintenance dose is determined on an individual basis.
