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Consider the need to adjust dose for conditions that increase opiate risk (eg elderly, co-morbidities, renal or hepatic impairment). Where dose equivalence is expressed as a range, use the value that produces the lowest equivalent dose and titrate as necessary.
SR - sustained release product. Guidelines for Patient-Controlled Intravenous Opioid Administration (PCA) for Adults with Acute Pain. The amount of opioid required to achieve comfort varies from patient to patient. Adjust dosing to achieve patient comfort with minimal side effects.
This opioid dose equivalence table is intended for comparison of different opioid and opioid formulations in individual patients or in patient cohorts. Caution is required if opioid dose equivalence tables are used to guide opioid switching, as the administration of a calculated ‘equivalent’ dose of the replacement opioid may lead to overdosage.
† See also Kreutzwiser D, Tawfic QA and Pain Guidelines (based on Quill TE: Primer of Palliative Care, ed. 7. Chicago, Academy of Hospice and Palliative Medicine, 2019). Chicago, Academy of Hospice and Palliative Medicine, 2019).
Oral Morphine Equivalents (OME) are approximations of the equianalgesic effects of other opioids compared to oral morphine. Thus, OMEs indicate how much of the reference drug oral morphine would be required to treat pain as effectively as the opioid morphine is compared with.
75 mcg, 150 mcg, 300 mcg, 450 mcg, 600 mcg, 750 mcg, 900 mcg ; 0.03
Demystifying Opioid Conversion Calculations a Guide for Effective Dosing is a thorough synopsis of opioid pharmacotherapy. The book concentrates on the important mathematical, pharmacokinetic, pharmacodynamic, and patient parameters that a pain medicine clinician needs to safely administer opioids.
