OPIOID CONVERSION GUIDE

OPIOID CONVERSION GUIDE

These conversions are a guide only. Patients may vary in their response to different opioids. After changing opioid, close assessment should follow and the dose altered as necessary.

Equianalgesic doses of oral opioids

Oral opioid

morphine hydromorphone oxycodone codeine tapentadol tramadol

Conversion factor (opioid dose x or ? by factor

= morphine dose)

x 5 x 1.5 ? 8 ? 3 ? 5

Practical equianalgesic

dose 10 mg

2 mg 5-7.5 mg* 75-90 mg*

50 mg* 50 mg

* dose guided by strength of medication available

Methadone conversions are complicated and prescribing should be restricted to medical

specialists with experience of methadone prescribing for pain management.

Subcutaneous route conversions

Opioid

morphine hydromorphone

Oral dose

30 mg 6 mg

Conversion factor

(oral dose ? by factor = subcut dose)

? 3 ? 3

Equianalgesic subcutaneous

dose 10 mg

2 mg

Transdermal preparation conversions

Opioid

buprenorphine fentanyl

Patch strength

5 microgram/hr 12 microgram/hr

Equianalgesic oral morphine dose 12 mg/24 hrs

30-45 mg/24 hrs

Sublingual preparation conversions

Opioid

buprenorphine tablet fentanyl tablet fentanyl lozenge

Dose

200 microgram 100 microgram 200 microgram

Equianalgesic oral morphine dose for pain 8-16 mg

no direct conversion initiate 200 microgram lozenge

and titrate to effect

February 2022

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