Immediate-release tablets indicate acute pain where opioid use is appropriate. ● Opioid naive patients: 10-20 mg orally every 4-6 hours initially and start with a 5 mg increment. ● Conversion from intravenous (IV) oxymorphone oral: absolute bioavailability of orally is 10% approx. Therefore, conversion from 1 mg IV dose every 4 to 6 hours is equipotent to 10 mg orally every 4-6 hours. ● Older adult patients should take 5 mg orally every 4-6 hours. Dosage for Chronic severe pain: ● Opioid naive patients: 5 mg orally every 12 hours initially, then titrated in increments of 5-10 mg every 12 hours within 3 to 7 days to a level that offers adequate analgesia and minimizes Opana side effects. ● Change from intravenous (IV) oxymorphone to extended-release oral: absolute bioavailability is 10% approx. Therefore conversion from one mg IV every 6 hours (4 mg per day) is equipotent to 20 mg by mouth every 12 hours (40 mg/day) The use of higher starting doses in patients who are non-tolerant to opioids may cause fatal respiratory depression.