Opioid Rotation

“opioid rotation.” What is the rationale behind it and what is meant by dose reduction for cross-tolerance?

Opioid rotation is a concept that takes advantage of the fact that there is incomplete cross-tolerance between the opioids. Periodically switching between opioids may benefit patients who inadequately respond to high doses of opioids due to tolerance, who are presumed to have “hyperalgesia,” or who suffer from adverse effects of higher doses. Cross-tolerance can be incomplete between any opioids, but is more incomplete between different chemical classes 


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