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Bidirectional conversions: When converting between certain opioids, the direction of conversion (eg, morphine to hydromorphone versus hydromorphone to morphine) will produce a different conversion ratio.
opioid conversion calculators. • Identify the mathematical disparities in conversion. • Compare automated conversions against manual calculations. • Reveal potential risks to the end user.
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.
Listed below are methods for common conversions using standard published conversion ratios. The examples assume a change in drug or route at a time of stable pain control using equianalgesic doses. See Fast Fact #2 about conversions involving transdermal fentanyl; #75 and #86 about methadone.
Opioid Conversion Tables . Ernest Dole , Pharm.D., BCPS , PhC, FASHP . Clinical Pharmacist , University of New Mexico Hospitals . Chronic Pain C onsultation ...
INSTRUCTIONS. Note: This is for converting oral opioids only, and should not be used for IV to oral conversions. For combination drugs (e.g. Percocet = acetaminophen + oxyCODONE), enter only the dose of the opioid component (e.g. if 5 mg/325 mg, enter "5").
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.
