• Sebastiano Mercadante.
• Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy. terapiadeldolore@lamaddalenanet.it
• Curr Med Res Opin. 2011 Dec 1;27(12):2373-6.

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

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