High doses of oxycodone in the pharmacotherapy of cancer pain case reports

The recommendations of the European Association for Palliative Care, EAPC from 2012 indicate oxycodone and hydromorphone in addition to morphine as first-line drugs for the relief of pain (moderate and strong) associated with cancer. In justified cases opioids such as fentanyl and buprenorphine can be used in transdermal systems. Several clinical trials confirmed therapeutic advantages resulting from the use of oxycodone as a semi-synthetic opioid. With a view to the effectiveness of analgesic therapy in a patient with cancer, we should use evidence-based pharmacotherapy according to the latest guidelines and most importantly therapy that requires individualization. Side effects, drug intolerance or hyperalgesia appearing during treatment force us to rotate opioids that should vary in their pharmacokinetic-pharmacodynamic profile.

In our work we describe two cases of patients where rotation from other strong opioids to oxycodone, with the use of high doses of the drug, largely improved analgesic efficacy in the course of pain treatment associated with advanced cancer as well as allowed to minimize the adverse effects of opioids.