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Patients switched from morphine
Case 1
This 82-year-old male patient had surgery to amputate his left leg, below the knee. He was started on prolonged release (PR) morphine (20 mg twice-daily), but experienced severe confusion. He was therefore switched to OxyContin® tablets (20 mg twice-daily), supplemented with a product from the OxyNorm® oral range* for breakthrough pain. Pain control was effective and he did not suffer from confusion.
*Formulation and dose not specified in case report
Patients switched from other opioids
Case 2
This 23-year-old female patient had symptoms of Crohn’s disease, which had not improved after formation of a pouch. She had surgery to excise the pouch and to perform an ileostomy. She received patient controlled analgesia (PCA) with morphine and pethidine for six days, followed by dihydrocodeine (30 mg four times daily). However, her pain was not controlled and she was therefore started on OxyContin® tablets (20 mg twice-daily). There was a significant improvement in her pain control and she was discharged from hospital after two days.
Case 3
This 67-year-old male patient had bone graft surgery on his ankle. He was treated with morphine by PCA, but he experienced nausea and euphoria and so he was switched to dihydrocodeine (30 mg four times daily), paracetamol (four times daily), and diclofenac (50 mg three times daily). However, his pain was not controlled so the dihydrocodeine was replaced with OxyContin® tablets (10 mg twice-daily), supplemented with a product from the OxyNorm® oral range* (5 mg, as required) for breakthrough pain. His pain control improved and he needed only one dose of escape medication (5 mg) over the next 24 hours. He had no nausea or euphoria and was described as being ‘very satisfied’ with his pain control.
*Formulation not specified in case report
Case 4
This 65-year-old male patient had undergone a hemihepatectomy two years ago because of metastatic tumours. He was admitted to hospital with biliary colic and had surgery for laparoscopic division of adhesions. He received morphine by PCA for 12 days. After the PCA was stopped, he received dihydrocodeine (30 mg every four hours) and intrapleural bupivicaine. He was then switched to OxyContin® tablets (20 mg twice-daily), supplemented with a product from the OxyNorm® oral range* for breakthrough pain. His pain was well controlled and he was discharged from hospital two days later. He was described as being pleased with the pain control achieved and he also stated that he had not felt ‘comfortable’ until he was prescribed OxyContin® tablets.
*Formulation and dose not specified in case report
To view more case studies on cancer-related pain using oxycodone hydrochloride, please click here