Order 32 mg Exalgo oral tablet extended release online
Generic name: HYDROMORPHONE HYDROCHLORIDE 8mg
Dosage form: tablet, extended release
2.1 Important Information on Dosage and Administration
Prescribers and pharmacists should be aware that hydromorphone is available in both immediate-release and extended-release 8 mg tablets to avoid prescription errors.
Only healthcare practitioners who are familiar with the use of powerful opioids for the treatment of chronic pain should prescribe EXALGO. Order 32 mg Exalgo oral tablet extended release online.
EXALGO is only recommended for people who are already opioid-tolerant due to the danger of respiratory depression. When starting EXALGO therapy, stop or taper any other extended-release opioids. Do not start any patient on EXALGO as the initial opioid because it is only for opioid-tolerant individuals.
Patients who receive at least 60 mg oral morphine per day, at least 25 mcg transdermal fentanyl per hour, at least 30 mg oral oxycodone per day, at least 8 mg oral hydromorphone per day, at least 25 mg oral oxymorphone per day, at least 60 mg oral hydromorphone per day, or an equianalgesic dose of another opioid for one week or longer are considered opioid-tolerant.
Use the lowest effective dose for the shortest time compatible with the treatment goals of each individual patient .Start the dose regimen for each patient separately, taking into account the patient’s prior analgesic treatment experience as well as the patient’s risk factors for addiction, abuse, and misuse.
Monitor patients for respiratory depression, especially within the first 24 to 72 hours of starting therapy and following EXALGO dosage increases, and modify the dosage as needed.
Patients should be told to take EXALGO pills whole. Crushing, chewing, or dissolving EXALGO pills results in uncontrolled hydromorphone distribution, which can end in overdose or death.
Initial Dosage (2.2)
Conversion to EXALGO from Other Oral Hydromorphone Formulations
Patients who are currently on oral immediate-release hydromorphone can be switched to EXALGO by giving them a starting dose that is equal to their entire daily oral hydromorphone dose, given once a day.
EXALGO Conversion from Other Oral Opioids
When EXALGO therapy is started, stop taking all other opioids around the clock.
The relative potency of different opioid medications and opioid formulations varies significantly from patient to patient. As a result, while establishing the total daily dosage of EXALGO, a conservative approach is recommended. It is preferable to underestimate a patient’s 24-hour oral hydromorphone dosage and offer rescue medication (e.g., an immediate-release opioid) than to overestimate the dosage and manage an adverse reaction due to overdose.
Patients were converted from their prior opioid to EXALGO in an EXALGO clinical trial with an open-label titration period, utilizing Table 1 as a guidance for the starting EXALGO dose. The beginning dose of EXALGO is indicated to be 50% of the calculated daily hydromorphone need. Using Table 1, calculate the expected daily hydromorphone requirement.
When using the data in Table 1, keep the following in mind:
This is not an equianalgesic dose table.
Only one of the listed oral opioid analgesics can be converted to EXALGO using the conversion factors in this table.
It is not possible to convert from EXALGO to another opioid using this table. This will result in an overestimation of the new opioid’s dose, which could lead to a lethal overdose.
Conversion Factors to EXALGO Order 32 mg Exalgo oral tablet extended release online
Prior Oral Opioid
Approximate Oral Conversion Factor
To calculate the approximate oral hydromorphone daily dose for patients on a single opioid, add the current total daily dose of the opioid and multiply it by the conversion factor.
Calculate the approximate oral hydromorphone dose for each opioid in a patient on a multi-opioid regimen and add the totals to get the approximate total hydromorphone daily dose.
Only employ the opioid component of these medicines in the conversion for patients on a fixed-ratio opioid/non-opioid analgesic regimen.
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