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    OPIOID ANALGESIC COMPARISON TABLE - Perkins

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    Apostolos T.
    This document provides a comparison table of opioid analgesic drugs including their equivalent parenteral and oral doses, onset times, peak effects, and durations of action. It also notes the usual dosing intervals. The table acts as a guideline for switching patients between opioids, though there is wide individual variability in opioid response. All doses should be titrated to the individual patient's effect. References are provided to support the dose conversions and opioid pharmacology.

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    OPIOID ANALGESIC COMPARISON TABLE - Perkins

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    Apostolos T.
    21 views2 pages
    This document provides a comparison table of opioid analgesic drugs including their equivalent parenteral and oral doses, onset times, peak effects, and durations of action. It also notes the usual dosing intervals. The table acts as a guideline for switching patients between opioids, though there is wide individual variability in opioid response. All doses should be titrated to the individual patient's effect. References are provided to support the dose conversions and opioid pharmacology.

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    This document provides a comparison table of opioid analgesic drugs including their equivalent parenteral and oral doses, onset times, peak effects, and durations of action. It also notes the usual dosing intervals. The table acts as a guideline for switching patients between opioids, though there is wide individual variability in opioid response. All doses should be titrated to the individual patient's effect. References are provided to support the dose conversions and opioid pharmacology.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    21 views2 pages

    OPIOID ANALGESIC COMPARISON TABLE - Perkins

    Uploaded by

    Apostolos T.
    This document provides a comparison table of opioid analgesic drugs including their equivalent parenteral and oral doses, onset times, peak effects, and durations of action. It also notes the usual dosing intervals. The table acts as a guideline for switching patients between opioids, though there is wide individual variability in opioid response. All doses should be titrated to the individual patient's effect. References are provided to support the dose conversions and opioid pharmacology.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    OPIOID ANALGESIC COMPARISON TABLE

    Drug Equianalgesic Doses Equianalgesic Parenteral Oral Usual


    Parenteral (IV, IM, SQ) Doses - Oral Onset Peak Duration Onset Peak Duration dosing
    (min) (min) (hours) (min) (min) (hours) Interval
    (hours)
    AGONISTS
    Morphine 10 mg 30 mg <5 SQ: 3-6 15-60 30-60 3-6 3-4
    30-60
    IV: 20
    Codeine 75-120 mg 130-200 mg 10-30 30-60 4-6 30-60 30-60 4-6 3-4
    Fentanyl 0.1 mg Transdermal 25 IM: 7- ND 1-2 IV: 1
    mcg/hr
    15 (TD: 48-72) TD: 72
    45 mg of oral
    sustained release IV: <1
    morphine
    Hydrocodone 30 mg ND ND 4-8 3-4
    Hydromorphone 1.5 mg 7.5 mg ND 30-60 4-6 15-30 30-60 4-6 3-4
    Levorphanol 2 mg 4 mg ND 30-60 4-8 10-60. 30-60 4-8 6-8
    Meperidine 100 mg 300 mg <5 30-60 2-4 10-15 30-60 2-4 2-3
    Methadone 10 mg++ 7.5 mg++ 10-20 30-60 4-8 30-60 30-60 4-8 6-8
    Oxycodone ND 20 mg <5 60 4 10-15 120- 4-6 4
    180
    Oxymorphone 1 mg 10 mg 5-15 30-60 3-6 10-15 30 4-6 3-6
    Tapentadol 100mg ND 1.25 hr 4-6 4-6

    PARTIAL
    AGONISTS
    Buprenorphine 0.4 mg ND 15 60 4-8 ~15 40-210 6-8
    SL admin SL admin
    Butorphanol 2 mg Not available IM: 30- 30-60 3-5 3-4
    60
    IV: 4-5
    Nalbuphine 10 mg Not available IM: 30 60 3-6 3-4
    IV: 1-3
    Pentazocine 60 mg 150 mg IV: 2-3 ~15 2-3 15-30 ~60 4-5 3-4

    Prepared by: Ruth Perkins, B.S., M.A., Pharm.D., BCPS


    Rev 04/2011
    ++ The ratio of PO morphine:PO methadone is dependent on the dose of morphine prior to switching to methadone. With low doses of morphine (<90 mg/day), the ratio is approximately 4:1
    (morphine:methadone). With higher doses of morphine, i.e. > 300 mg/day, the ratio of PO morphine: PO methadone approaches 12:1. Inbetween, a ratio of 8:1 has been studied. (Davis,2001)
    ND – not determined

    The opiate analgesic comparison chart is meant to act as a guideline when switching patients from one opioid to another. It is important
    to recognize that there is a wide variation in response to opiates between individuals. Therefore, all doses should be titrated to effect for
    individual patients. (Foley, 1985 and Pereira, 2000)

    REFERENCES
    Pereira, J; Lawlor , P; Vigano, A; et al. Equianalgesic Dose Ratios for Opioids: A Critical Review and Proposals for Long-Term
    Dosing. J Pain Symptom Manage 2001;22:672-687

    Davis, MP and Walsh, D. Methadone for relief of cancer pain: a review of pharmacokinetics, pharmacodynamics, drug interactions and
    protocols of administration. Support Care Cancer 2001;9:73-83.

    Foley, K. The treatment of cancer pain. NEJM 1985; 313: 84-95.

    Prepared by: Ruth Perkins, B.S., M.A., Pharm.D., BCPS


    Rev 04/2011

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