Memory Joggers: Medication Information
Equianalgesic Chart: Approximate equivalent doses of opioids for moderate to severe pain
|
Equianalgesic Dose (mg)
|
| |
IM |
PO |
PR |
| Morphine |
10 |
30 |
|
| Codeine |
130 |
200 |
|
| Hydromorphone |
1.5 |
7.5 |
|
| Levorphanol |
2 |
4 |
|
| Meperidine HCl |
75 |
- |
|
| Methadone HCl *See note below |
10 |
20 |
|
| Oxycodone HCl |
15 |
30 |
|
| Oxymorphone HCl |
1 |
|
10 |
*For hydrocodone and oxycodone, the equivalent of four to eight 5-mg tablets daily equals about 10 mg of sustained-release oxycodone twice daily, or 15 mg of sustained-release morphine twice daily. The equivalent of 10 5-mg hydrocodone or oxycodone tablets daily is about 25 mcg of fentanyl every 48-72 hours (transdermal) or 5 mg of methadone twice daily.
The equinalgesic dose of morphine to methadone, however, varies as the dose of morphine increases. Dose ratios vary from 4:1 at morphine doses of 30 to 90 mg to 6:1 at 90 to 300 and 8:1 at doses of greater than 300 mg morphine.
Methadone is longer acting than morphine when given repeatedly. Long half-life can lead to delayed toxicity from accumulation within 3-5 days. Start PO dosing on PRN schedule; in opioid-tolerant patients converted to methadone, start with 10-25% of equianalgesic dose. |
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