Table 3.

Commonly Used Step 3 Opioids

DrugDosage Form (Brand Name)Usual Adult DosageCost*
Immediate-Release Product
    MorphineIV: 1, 2, 4, 5, 8, 10, 15, 25, 50 mg/mLIV: 2–10 mg$18–30/100s tab; $9–13/100 mL liquid; $15–30/12s supp
Tablets: 15, 30 mg (MSIR, generic)SC/IM: 10 mg q4 hours
Liquid: 10 mg/5 mL, 20 mg/5 mL, 20 mg/mL, 100 mg/5 mL (Roxanol, others)PO: 10–30 mg q4 hours
Suppositories: 5, 10, 20, 30 mg (various)Rectal: 10–20 mg q4 hours
    HydromorphoneIV: 1, 2, 4, 10 mg/mL (Dilaudid, others)IV/IM/SC: 1–4 q4–6 hours$37–70/100s tab; $22/6s supp
Tablets: 1, 2, 3, 4, 8 mg (Dilaudid, others)PO: 2–6 mg q3–4 hours
Liquid: 5 mg/5 mL (Dilaudid, others)Rectal: 3 mg q6–8 hours
Suppositories: 3 mg (Dilaudid, others)
    OxycodoneTablets: 5 mg (Percolone, Roxicodone)PO: 10–30 mg q 4 hours$30–36/100s tab
Capsules: 5 mg (OxyIR)
Liquid: 5 mg/5 mL (Roxicodone), 20 mg/mL (Roxicodone Intensol, OxyFAST)
    MeperidineIV: 10, 25, 50, 75, 100 mg/mL (various)IV/IM/SC: 50–100 mg q3–4 hours$68/100s tab
Tablets: 50, 100 mg (Demerol, various)PO: 50–100 mg q3–4 hours
Liquid: 50 mg/5 mL (Demerol, various)
Sustained-Release Products
    Morphine Sustained-Release§SR Tablets: 15, 30, 60, 100, 200 mg (MS Contin, Oramorph SR)Not recommended for initial therapy$90, $171, $334, $511/100s tabs
    Oxycodone Controlled-Release§CR Tablets: 10, 20, 40, 80 mgOpioid-naive patients: 10 mg q 12 hours, and titrate$124, $238, $422, $793/100s
    Fentanyl Transdermal PatchTransdermal Patch: 25, 50, 75, 100 μg/hr (Duragesic)Opioid-naïve patients: 25 μg/hr every 3 days$62, $102, $163, $203/5s
Opioids with Long Duration of Action
    LevorphanolTablets: 2 mg (Levo-Dromoran)PO: 2–4 mg q 6–8 hours$87/100s
    MethadoneTablets: 5, 10, 40 mg (Dolophine, others, generic)PO: 5–20 mg Q 6–8 hours$9, $15, $37/100s
  • * Cost based on generic pricing listed in 2001 Drug Topics Redbook.

  • Not recommended for cancer pain.

  • Not recommended for initial therapy.

  • § Tablets are not to be chewed or crushed.