Individualized dosing. Initial dose based on patient's opioid history, including degree of opioid tolerance, current general condition and medical status. Replace patch every 72 hr. If analgesia is insufficient during the 1st application, replace the patch w/ a patch of the same dose after 48 hr or increase dose when new patch is applied after 72 hr. May subsequently be titrated upwards or downwards, if required, in increments of 12 or 25 mcg/hr depending on response & supplementary analgesic requirements.