Oliceridine

FDA label

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Renal No adjustment needed

Hepatic Mild-moderate: no initial-dose change but may need less frequent dosing; severe: reduce initial dose and space subsequent doses

PCA demand dose 0.35 mg with 6-min lockout (may consider 0.5 mg); supplemental 0.75 mg beginning 1 h after initial dose, then hourly PRN

Instructions

• For IV administration only
• Use lowest effective dose for shortest duration
• Do not exceed a cumulative 27 mg/day (QT prolongation risk)
• CYP2D6 poor metabolizers may require less frequent dosing

Contraindications

• Significant respiratory depression
• Acute or severe bronchial asthma in an unmonitored setting or without resuscitative equipment
• Known or suspected GI obstruction, including paralytic ileus

Cautions

• Opioid-induced hyperalgesia/allodynia
• QT prolongation at daily doses >27 mg
• Life-threatening respiratory depression in chronic pulmonary disease or elderly/cachectic/debilitated
• Adrenal insufficiency
• Severe hypotension; avoid in circulatory shock
• Risk with increased ICP/head injury/impaired consciousness

Adverse reactions

• Nausea
• Vomiting
• Dizziness
• Headache
• Constipation
• Pruritus
• Hypoxia

Pregnancy No human data; prolonged use in pregnancy can cause neonatal opioid withdrawal syndrome

Lactation Presence in human milk unknown; monitor breastfed infant for excess sedation and respiratory depression