Characteristics and comments
Codeine Step II drug only: use alone or in combination with
paracetamol; daily doses ≥360 mg not recommended
Tramadol Step II drug only: use alone or in combination with
paracetamol; daily doses ≥400 mg not recommended
Hydrocodone Step II drug only: used as a substitute
for codeine in some countries
Oxycodone Step II opioid when used at low doses (eg, ≤20 mg
per day) alone or in combination with paracetamol
Morphine Step II opioid when used at low doses
(eg, ≤30 mg per day)
Hydromorphone Step II opioid when used at low doses
(eg, ≤4 mg per day)
*Originally classifi ed as weak opioids.
Table 1: WHO step II opioids* for moderate cancer pain in opioid-naive
patients