The use of high doses of OROS hydromorphone in an acute palliative care unit

Abstract

Objectives:

To characterize patients who received high doses of OROS hydromorphone (OROD-HY), a retrospective study of patients admitted in an acute pain relief and palliative care unit for a period of two years (from June 2009 to June 2011) was performed.

Methods:

Globally, 79 patients were prescribed OROS-HY during admission at mean maximum doses of 68 mg/day (±42). Twenty-two patients were switched from other opioids to OROS-HY and 16 patients were switched from OROS-HY to other opioids. Sixty-three patients were discharged home with a prescription of OROS-HY with doses of 53 mg/day (±44). Doses were significantly lower in older patients (p < 0.005). The mean admission time was 6.1 days (±3.2). During admission 10 patients (12.6%) were prescribed doses of OROS-HY of more than 64 mg/day.

Results:

The maximum mean doses of this group of patients reached during admission were 238 mg/day. Eight of them were successfully treated and discharged home with doses of 175 mg/day. Two patients did not achieve an adequate balance between analgesia and adverse effects and received alternative treatments.

Conclusion:

This study demonstrated that OROS-HY administered in larger doses was relatively safe and effective, showing versatility and flexibility similar to other opioids.

Key words::

• Cancer pain
• High doses
• OROS hydromorphone

Transparency

Declaration of funding

S.M. has received no payment in preparation of this manuscript.

Declaration of financial/other relationships

S.M. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.