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Example of IV opioid dosing for adult patients in the PACU

Example of IV opioid dosing for adult patients in the PACU
Opioid Dose range Onset and peak of analgesia* Interval
Hydromorphone 0.2 to 0.5 mg <5 minutes, peak effect 10 to 20 minutes Every 5 minutes as needed
Morphine 1 to 3 mg 5 to 10 minutes; peak effect within 20 minutes Every 5 to 10 minutes as needed
Fentanyl 25 to 50 mcg <1 minute, peak effect 2 to 5 minutes Every 2 to 5 minutes as needed
Oliceridine 1.5 mg initial dose, 0.75 mg subsequent dose <5 minutes FDA label limits dosing to no more than hourly

IV: intravenous; PACU: post anesthesia care unit; FDA: Food and Drug Administration.

* Onset and peak analgesia varies and may be influenced by factors such as dose and co-medications; typical values are provided for purposes of comparison.

¶ After initial two doses, oliceridine dose may be titrated, if needed, based on tolerability and response up to a maximum of 3 mg per dose, at intervals of one hour or more; maximum cumulative dose is 27 mg per day due to risk of QT prolongation.
Graphic 140311 Version 3.0

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