Rational opioid dosing in the elderly: dose and dosing interval when initiating opioid therapy

Clin Pharmacol Ther. 2012 Feb;91(2):339-43. doi: 10.1038/clpt.2011.307. Epub 2011 Dec 28.


Opioids are the mainstay of treatment for moderate to severe pain. However, opioid therapy in the elderly is often associated with significant morbidity because of excessive ventilatory depression. The large amount of interindividual variability in opioid dose-response relationships makes it difficult to individualize the dose and dosing interval to provide safe and effective analgesia. By examining how aging affects the pharmacokinetics (PK) and pharmacodynamics (PD) of opioids, it is possible to provide a rational basis for age adjustment in opioid dosing.

MeSH terms

  • Aged*
  • Aged, 80 and over*
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / pharmacokinetics
  • Analgesics, Opioid / pharmacology
  • Delayed-Action Preparations / administration & dosage*
  • Delayed-Action Preparations / adverse effects
  • Delayed-Action Preparations / pharmacokinetics
  • Delayed-Action Preparations / pharmacology
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule*
  • Drug Dosage Calculations*
  • Humans
  • Pain Management / methods*
  • Pain Management / standards*


  • Analgesics, Opioid
  • Delayed-Action Preparations