CAUTION: This calculator is intended for calculating the Morphine Equivalent Dose (MED) dose for a patient taking one or more opioid medications. It should not be used to determine doses when converting a patient from one opioid to another. Equianalgesic dose ratios are only approximations and do not account for.
For the dose entered, these two conversion ratios are:
Tramadol IR: Maximum (age up to 75 years): 400 mg/day; Maximum (75 years and older): 300 mg/day.
Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The creation of this tool was supported by the Cooperative Agreement, Number 6 NU17 CE, funded by the Centers for Disease Control and Prevention.
( CDC guideline recommendation #11 ).
Oxycodone, Not determined, 20 mg. Oxymorphone, 1 mg, 10 mg. Tapentadol, Not available, 100 mg. Tramadol, Not available5, Not available5. Partial Agonists. Buprenorphine (IV, IM)2, 0.4 mg, Not determined. Buprenorphine (TD)6, Not determined, See footnote 6 for conversion. Butorphanol, 2 mg, Not available.
Use of this website is conditional upon your acceptance of our Disclaimer, Terms and Conditions.
Jeffrey Fudin and Jason Andrew Fudin, B.Eng., MS) Formula when converting to methadone: Methadone mg = X/21 Formula when converting from methadone: Methadone mg = X/21. 4 Methadone Fudin Factor (Developed by Dr.
Prepared by: Ruth Perkins, B.S., M.A., Pharm.D., BCPS. Rev: 014/2012.
1 When converting patients from one opioid to another it is recommended to decrease the dose of the new opiate in half (after calculations) due to incomplete cross-reactivity between opiates in terms of analgesia and respiratory depression.
Generally, an immediate-release form of the same opioid is used (eg, morphine IR with morphine SR). The size of the breakthrough dose should be 5-15% of the patient's 24-hour baseline dose. In an inpatient setting, rescue doses can be provided IV every 15-30 minutes.
Because equianalgesic tables are inherently inaccurate, dose titration to optimal effect is essential. Most guidelines recommend a dose increase or decrease of 25-50% from the previous day. 3 Loading. Show AMA citation. 12, 13 In patients with long-acting formulations ( SR ), the amount of rescue doses needed in the previous day may be added to the patient's long-acting formulation. Because transdermal fentanyl has a delayed onset and onset of peak activity, consider titrating every 3 days.
When switching between opioids, equianalgesic conversions may overestimate the potency of the new opioid due to incomplete cross-tolerance.
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.
Parenteral hydromorphone is 20 times as potent as oral morphine 30mg Oral morphine Fentanyl NA 15 micrograms/hr Transdermal fentanyl is approximay 80 times as potent as morphine.
Write to your doctor about what matters most to you.
It's free, easy and extremely importantI.
Meperidine is not a recommended drug in a palliative care setting and is to be avoided.
Like this: Like Loading. Opioid Conversion Pre-Test General Guidelines Opioids Equivalency Table Equianalgesic Doses Land Mines Teaching Exercise 1: Converting from oral to parenteral morphine The Case Continues Teaching Exercise 2: Converting from oral morphine to fentanyl transdermal patch Opioid Conversion Tutorial Levy’s Rule Example 1 Example 2 Pearls Post test Resources Appendices How to institute opioid therapy Communication with patients and family on pain treatment Parenteral to oral conversion ratios of common opioids Facts about the fentanyl transdermal patch Using opioid infusions to palliate pain Author Physician Assisted Death: Real Stories Dr. W. Richard Scott, Professor Emeritus in the Department of Sociology, shares a very personal story of the last stages of life of his beloved brother Charles Scott.
Learn about the finer points of the Aid in Dying law in our new module on Physician Assisted Death.
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.
(This is based on studies converting from Morphine to fentanyl. Currently, there are no empirical studies converting fentanyl to morphine). 30mg Oral morphine Meperidine.
Equianalgesic dose ratios are only approximations and do not account for genetic factors, incomplete cross-tolerance, and pharmacokinetics. † There are special considerations for calculating Methadone (Methadose, Dolophine) MED, please view the following page for conversion factors and references: Methadone.
† There are special considerations for calculating Methadone (Methadose, Dolophine) MED, please view the following page for conversion factors and references: Methadone Conversion Factors.
← Back to AMDG Home.
*NOTE: All doses expressed in mg per day with exception of fentanyl transdermal, which is expressed in mcg per hour.
Equianalgesic dose ratios are only approximations and do not account for genetic factors, incomplete cross-tolerance, and pharmacokinetics. This is especially important for fentanyl and methadone conversions. CAUTION: This calculator should NOT be used to determine doses when converting a patient from one opioid to another.
For more info, please refer to the guideline at: AMDG - 2015 Guideline /guideline.htm. This opioid dose calculator was developed by the Washington State Agency Medical Directors' Group to be used in conjunction with the Interagency Guideline on Prescribing Opioids for Pain.
Please note: this calculator is not compatible with IE 7 or below. For technical questions or comments, please contact: AMDG Web Support AMDG IT Support at.
Opioid Dose Calculator.