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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