A patient developing tolerance to oxycodone for chronic pain should be treated with which medication?

In the context of managing a patient who is developing tolerance to oxycodone for chronic pain, buprenorphine/naloxone presents an effective treatment option. Buprenorphine is a partial opioid agonist that can provide analgesic effects while also having a ceiling effect on its opioid activity, which may help in reducing the risk of overdose compared to full agonists like oxycodone. The inclusion of naloxone helps to deter misuse of the medication if the patient were to attempt to misuse it by injection, as naloxone can precipitate withdrawal in such cases.

One of the key aspects of treating patients with chronic pain who develop tolerance is to consider options that not only manage pain effectively but also minimize the potential for escalating doses of opioids. Buprenorphine/naloxone provides this balance, offering a pain management strategy that is effective while addressing concerns related to opioid dependence and misuse.

When comparing other options, duloxetine is an antidepressant that is often used for neuropathic pain and has a different mechanism of action compared to opioids, while gabapentin is primarily utilized for nerve pain and does not have opioid effects. Extended release oxycodone would simply continue the same opioid regimen, heightening concerns about tolerance and