As-needed dose of short-acting opioid to provide relief of intermittent breakthrough pain.
The usual dose for rescue medication ranges between 5% and 15% of the total daily dose.
The interval should be long enough to observe the full effect of each dosage; in the case of oral opioids, a schedule of every 2 hours is appropriate.
Indelicato RA, Portenoy RK. Opioid rotation in the management of refractory cancer pain. J Clin Oncol. 2003. 21(9s), 87s-91s.
It is used to treat episodic or breakthrough pain; it is made available on a prn (as needed) basis in addition to a patient's regular dose; it is an important part of managing pain, dyspnea, and cough.
Appropriate “rescue” dosing:.
- 10% of the total opioid dose is given every 1 to 2 hours as needed
- In the elderly, the rescue dose should be 5% of the total opioid dose administered every 4 hours as needed.
- When using slow release preparations, intermediate release (IR) opioids are provided for breakthrough pain with the dose being 1/6th to 1/3rd of the q12 hr dose (equivalent to 50% to 100% of the q4 hour dose).