Effect of subcutaneous oxycodone for end-stage heart failure due to severe aortic stenosis - A case report.

It is difficult to manage the symptoms of patients who are dying of end-stage heart failure (HF). Opioids are sometimes required to relieve their symptoms in addition to oxygen therapy and medical management. Oxycodone is a µ receptor agonist that is known to be a safer opioid than morphine in patients with chronic kidney disease (CKD) because its metabolites have weak pharmacological activity. We treated a 99-year-old woman who had end-stage HF (secondary to severe aortic stenosis) and CKD. It was also difficult to maintain an intravenous line because of severe edema. We administered oxycodone subcutaneously and successfully alleviated her severe symptoms without severe adverse effects of opioids until a few days before her death. We report this case and discuss the possibility of using subcutaneous oxycodone as a new palliative care strategy in patients with end-stage HF. .