title: The use of high doses of OROS hydromorphone in an acute palliative care unit.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  This study demonstrated that OROS-HY administered in larger doses was relatively safe and effective, showing versatility and flexibility similar to other opioids.
authors.affiliation: Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy. terapiadeldolore@lamaddalenanet.it
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods; D010166:Palliative Care; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D004091:Hydromorphone