Initiating Hysingla ER therapy for chronic pain treatment in appropriate patients
Available in 7 dosage strengths for individualized treatment
This wide range of dosage strengths (from 20 to 120 mg) allows you to adjust the Hysingla ER dose up or down to achieve balance between management of pain and opioid-related adverse reactions.
The starting dose for patients who are not opioid-tolerant is Hysingla ER 20 mg orally every 24 hours. Daily doses of Hysingla ER greater than or equal to 80 mg are only for use in patients in whom tolerance to an opioid of comparable potency has been established. Patients who are opioid-tolerant are those receiving, for one week or longer, at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or an equianalgesic dose of another opioid. Use of higher starting doses in patients who are not opioid-tolerant may cause fatal respiratory depression.
Make an appropriate transition to Hysingla ER
- Initiate the dosing regimen for each patient individually; taking into account the patient's severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse
- Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals
- Monitor patients closely for respiratory depression, especially within the first 24 to 72 hours of initiating therapy and following dosage increases with Hysingla ER and adjusting the dosage accordingly
- Instruct patients to swallow Hysingla ER tablets whole, one tablet at a time, with enough water to ensure complete swallowing immediately after placing in the mouth
- Instruct patients not to pre-soak, lick, or otherwise wet the tablet prior to placing in the mouth
- Crushing, chewing, or dissolving Hysingla ER tablets will result in uncontrolled delivery of hydrocodone and can lead to overdose or death
Dosage modifications in patients with severe hepatic impairment
- Patients with severe hepatic impairment may have higher plasma concentrations of hydrocodone than those with normal function
- Initiate therapy with 1/2 the initial dose of Hysingla ER in these patients and monitor closely for respiratory depression, sedation, and hypotension
Dosage modifications in patients with moderate to severe renal impairment
- Patients with moderate to severe renal impairment and end-stage renal disease may have higher plasma concentrations of hydrocodone than those with normal function
- Initiate therapy with 1/2 the initial dose of Hysingla ER in these patients and monitor closely for respiratory depression, sedation, and hypotension
