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End of Life Online Curriculum - Modules
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Pain Control: Opioid Conversion
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Opioid Equivalency Table
Drug |
Oral/Rectal Route |
Parenteral Route |
Conversion Ratio to
Oral Morphine |
Equianalgesic Dose of Oral Morphine |
| Morphine sulfate |
30mg Oral morphine |
10mg of parenteral morphine |
Parenteral morphine is 3
times as potent as oral morphine |
30mg
Oral morphine |
| Oxycodone |
20mg of oral oxycodone |
NA |
Oral Oxycodone is roughly
1.5 times more potent than oral morphine |
30mg
Oral morphine |
| Hydrocodone |
20mg of oral hydrocodone |
NA |
Oral hydrocodone is roughly
1.5 times more potent than oral morphine |
30mg
Oral morphine |
| Hydromorphone |
7mg of oral hydromorphone |
1.5mg of parenteral hydromorphone |
Oral hydromorphone is about
4-7 times as potent as oral morphine
Parenteral hydromorphone is 20 times as potent as oral morphine |
30mg
Oral morphine |
| Fentanyl |
NA |
15 micrograms/hr |
Transdermal fentanyl is approximately
80 times as potent as morphine
(This is based on studies converting from Morphine to fentanyl. Currently,
there are no empirical studies converting fentanyl to morphine). |
30mg
Oral morphine |
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Meperidine
Meperidine is not a recommended drug in a palliative
care setting and is to be avoided.
If a patient with chronic pain is on meperidine, convert
patient to an equianalgesic dose of one of the other opioids listed
in this table. |
300mg of oral meperidine |
75mg of parenteral meperidine |
Oral Morphine is about 10 times more potent than oral meperidine
and about twice more potent as parenteral meperidine (mg for mg) |
30mg
Oral morphine |
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©End
of Life Curriculum Project, a joint project of the US Veterans Administration
and SUMMIT,
Stanford University Medical School. Funded by a grant to the Veterans
Administration Nationwide Palliative Care Network by
the National Library of Medicine. VJ Periyakoil, MD, Director.
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