Early introduction of intravenous oxycodone injection followed by quick titration to oral oxycodone in outpatient cancer pain treatment in opioid-naïve patients: "oxycodone bridge method".

Following opioid therapy initiation in opioid-naïve outpatients, cancer-related pain does not improve immediately, and pain relief is maintained after many days. This prospective study aimed to evaluate the feasibility of quick opioid introduction with injectable oxycodone for outpatient cancer-related pain and bridge to oral persistent-release tablet. Patients with Numerical Rating Scale of ≥4 for cancer-related pain were included. Injectable oxycodone 2 mg was evaluated for efficacy and safety after 30 min of administration; in case of lower efficacy, injectable oxycodone was administered for another 30 min. For patients exhibiting improvement 30 and 60 min after injectable oxycodone administration, oral persistent-release tablet 5 and 10 mg were initiated, respectively. If side effects are acceptable, oral persistent-release tablet twice daily was prescribed. The final evaluation for its efficacy and safety was conducted at revisit. Overall satisfaction (1-5 points, higher points are better) was evaluated. The study included 23 patients (26 symptoms). The Numerical Rating Scale was improved from 6.7 ± 1.9 to 2.5 ± 2.5 and 1.3 ± 1.3 at 30 min after injectable oxycodone and revisit, respectively. Five patients with six symptoms receiving 60 min of injectable oxycodone had Numerical Rating Scale of 3.7 ± 1.7 and 1.7 ± 1.2 at revisit. No patient had Grade 3 or higher side effect during injectable oxycodone and at revisit. The overall satisfaction was 4.4 ± 0.8. In conclusion, early injectable oxycodone introduction for opioid-naïve outpatients can be feasible and useful as a quick bridge to oral persistent-release tablet.