The Elizabeth Hospice Palliative Reference Cards

MEDICATION KINETICS

Generic Name ANALGESICS Acetaminophen

T Cmax

Elimination t ½

Generic Name

T Cmax

Elimination t ½

OPIOIDS Codeine (methylmorphine) EM

PO: 1 hr (1–2) PR: 1 hr (1.8–4.8) PO: buffered tab: 20 min PO: effervescent solution: 15 min IR PO: (Diclofenac K): 1 hr (0.33–2) ER PO: (Diclofenac Na): 2 hrs (1–4) PR: 30 min

4 hrs (2–4)

PO: 1 hr (1–2) PR: 30 min IM: 30 min

4 hrs (3.5-5.3)

(paracetamol) EM aka Tylenol

Fentanyl

Epi: 30 min TM: 24 min (20–40) SC/IM: 30 min IV: 15 min (6–15) TD: 12-24 hrs PO IR: 1 hr (1.3) PO ER: 5 hrs PO IR: 1 hr (48–60 min) SC/IM: 30 min IV: 15 min (6–15) Epi: 8 min

4 hrs (3.3–4.1) DI TD: 48-72 hrs

Acetylsalicylic acid (ASA) (salicylic acid derivative)

6 hrs (4.7–9,

aka Duragesic

dose–related)

Diclofenac

2 hrs

Hydrocodone in combination with acetaminophen aka Lortab, Vicodin, Zohydro ER

4 hrs (3.8–4.5) DI ER: 8-12 hrs

(acetic acid derivative) aka Cataflam, Voltaren

Hydromorphone aka Dilaudid ER aka Exalgo

4 hrs (3–4) DI ER: 8-12 hrs

Celecoxib (COX-2) aka Celebrex

PO: 3 hrs

11 hr

Ibuprofen (propionic acid derivative) EM aka Advil, Motrin Ketorolac (acetic acid derivative) aka Toradol Naproxen (propionic acid derivative) aka Aleve, Naprosyn Indomethacin (Indole acetic acid derivative) aka Indocin

PO: 1 hr (1.4–1.9 hrs )

4 hrs (2-4)

Methadone

PO: 2–4 hrs

Biphasic (variable) Initial phase 12–24 hrs ; Second up to 55+ hrs

(not 1 st order kinetics) aka Dolophine EM IR aka Roxanol ER aka MS Contin

PO: 1 hr SC/IM: 1 hr IV: 1–3 min

6 hrs (2.4-9)

Morphine

PO IR: 1 hr PO ER: 4 hrs (3-6) SC/IM: 30 min IV: 15 min (6–15)

4 hrs DI ER: 8-12 hrs

IR PO: 2 hrs (2–4)

12 hrs (12–15)

Oxycodone

PO IR: 1 hr PO ER: 5 hrs

4 hrs (3-5) DI ER: 8-12 hrs 5 min (3–10)

ER aka OxyContin

PO/PR: 2 hrs

4.5 hrs (2.6-11)

Remifentanil Sufentanil

1–3 min

SC: 30 min IV: 15 min (6–10)

2.5 hr

Tramadol

PO: 2 hr

Tramadol: 6.3 hr Metabolite: 7.4 hr

aka = also known as IR = Immediate Release ER = Extended Release EM = Essential Medicine as defined by WHO and IAHPC

aka Ultram

62 NB: These Reference Cards do not replace careful clinical judgment specific to each patient / family situation. PCIC: Palliative Care Interdisciplinary Curriculum is a collaborative effort of OhioHealth, The Ohio State University Wexner Medical Center, and Nationwide Children’s Hospital in Columbus, Ohio, USA, and other contributors. Permission to reproduce any or all of these PCIC Reference Cards is granted for non-commercial educational purposes only, provided that the attribution statement and copyright are displayed. To reproduce for all other purposes, contact Frank D. Ferris at info@pallmed.us. Copyright © Frank D Ferris 2013-2024. All rights reserved. V14.1, 2024

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