Successful switch from transdermal buprenorphine to oral controlled-release oxycodone in a patient with locally advanced prostate cancer: a case report and review of the literature

The aim of this case report is to depict a patient with locally advanced prostate cancer who was successfully switched from transdermal buprenorphine to oral, controlled-release oxycodone. A 79-year-old man was admitted to the palliative medicine out-patient clinic due to progression of prostate cancer after radical radiotherapy. His main complaint was pain in the perineum of severe intensity. The patient was treated with transdermal buprenorphine (TB) starting with the dose of 35 μg/h, subsequently increased to 52.5 μg/h and finally to 70 μg/h but after 4 months analgesia was unsatisfactory. In addition, the patient experienced drowsiness. TB was stopped and oxycodone controlled-release 10 mg twice daily was started, after 2 days increased to 20 mg twice daily, achieving satisfactory analgesia and less drowsiness. No significant adverse effects were present apart from moderate constipation controlled with lactulose. The patient continues his regimen with success and improvement in his quality of life.