When converting between opioids, prescribers and patients should be aware of the likelihood of incomplete cross tolerance. Many clinical situations may warrant discontinuation of chronic opioid therapy (COT) and will require multi-disciplinary team (medical, pharmacy, behavioral health) approaches to accomplish.
Office of the Director/Diversity Management and Equal Employment Opportunity Staff - 08E61.
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* Information adapted from UpToDate/Lexicomp.
The Centers for Disease Control and Prevention (CDC) recently launched a new mobile app for health care providers. This application is designed to help providers apply the recommendations of CDC’s Guideline for Prescribing Opioids for Chronic Pain into clinical practice by putting the entire guideline, tools and resources in the palm of their hand.
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WA State Agency Medical Directors Group.
The Jurnista product monograph recommends a 5:1 oral morphine:oral hydromorphone conversion ratio. When converting from immediate-release hydromorphone, the Jurnista dose should be rounded down. Per the product labeling, oral oxymorphone 10 mg ER is approximay equivalent to hydrocodone 20 mg or oxycodone 20 mg.
PHARMACIST'S LETTER / PRESCRIBER'S LETTER Equianalgesic doses contained in this chart are approximate, and should be used only as a guideline. See our Opioid. Conversion Algorithm for instructions on converting from one opioid to another. A website with an equianalgesic dose calculator is available at.
See our PL Chart, Equianalgesic Dosing of Opioids for Pain Management, for more information. Example 1 *NOTE: a conversion factor of 30 mg oxycodone=30 mg morphine could be used to arrive at an even more conservative estimate. Cite this document as follows: PL Detail-Document, Opioid Conversion Algorithm.
Do NOT use opioid conversion charts for methadone or noninjectable fentanyl. For these, see our PL Detail-Document. Cross-titration schedule. Consider this as an alternative to conversion charts for patients who don't need a sudden switch. In this case, start the new opioid at the lowest available dose AND decrease the.