090714 opioid conversions

[Pages:3]OPIOID CONVERSIONS

The conversions below are approximate and vary between individuals. At higher doses these variations require the consideration of a reduction in the dose when converting from one strong opioid to another as there is a risk of sedative side effects.

NB. The breakthrough dose of any opioid except fentanyl should be one sixth of the total daily dose. See note below on renal failure.

Oral weak opioids

Drug/Preparation Maximum

Equi-analgesic dose of oral morphine

daily dose

in 24 hours to maximum daily dose of

preparation

Codydramol*

8 tablets

8mg

Cocodamol 8/500*

8 tablets

5mg

Cocodamol 30/500* 8 tablets/capsules

20mg

Codeine phosphate

240mg

20mg

Dihydrocodeine

240mg

25mg

Tramadol

400mg

40mg

*Contains paracetamol 500mg per tablet/capsule

Oral and subcutaneous strong opioids

Drug

Morphine (oral) Morphine (sc) Morphine (iv) Diamorphine (sc) Oxycodone (oral) Oxycodone (sc) Alfentanil (sc) Fentanyl (sc) Hydromorphone (oral) Hydromorphone (sc)

Conversion ratio from oral morphine 1 2 to 1 3 to 1 3 to 1 1.5-2 to 1 3 to 1 30 to 1 150 to 1 7.5 to 1 15 to 1

Equi-analgesic Example conversions dose to 30 mg (These apply to single oral morphine doses or total daily dose)

30mg 15mg 10mg 10mg 15-20mg 10mg 1mg 200mcg 4mg 2mg

1. To convert 60 mg of oral Morphine to subcutaneous Morphine divide by 2 to give 30 mg.

2. To convert 30 mg of oral Morphine to oral Oxycodone divide by 2 To give 15mg

Transdermal opioids

Fentanyl patch (mcg/hr) 12 25 37 50 75 100 125 150 175 200 225 250

Buprenorphine patch (mcg/hr)

35 52.5 70 105 140

This is debated ? may be stronger than recorded here

24 hour oral morphine dose (mg) ................
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