Equianalgesic Tables

EQUIANALGESIC TABLE FOR CHRONIC OPIOID DOSING


DRUG ORAL (PO) PARENTERAL (SC, IV)
Morphine 10 mg 5 mg1
Codeine 100 mg 65 mg
Hydromorphone 2 mg 1 mg2
Oxycodone 5.0-7.5 mg -
Methadone 1 mg but highly variable ratio & complex3 Not readily available
Fentanyl transdermal patch 25 ug patch ≅ 60-134 mg oral morphine daily dose MEDD4

NOTE: Due to incomplete cross-tolerance between opioids, it is often necessary to reduce equivalent dose of new drug by 25% to 50%, and then titrate

RECOMMENDED INITIAL DOSE FOR OPIOID CONVERSION TO DURAGESIC® (FENTANYL) PATCH


Oral 24-hour morphine equivalent daily dose (MEDD mg/day) (ug/hour) Duragesic® dose equivalent (ug/hour)
60-134 25
135-224 50
225-314 75
315-404 100
405-494 125
495-584 150
585-674 175
675-764 200
785-854 225
855-944 250
945-1034 275

SOURCES/REFERENCES

  1. Janssen-Ortho 2006
  2. Downing GM, Wainwright W, editors. Medical care of the dying. 4th ed. Victoria (BC): Victoria Hospice Society; 2006. p. 195,201.

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