Dose Equivalence Table for Opioid Analgesics

Equianalgesic tables aid the clinician in making these conversions by providing a rough estimate for starting doses of the new opioid that may produce approximately the same amount of analgesia. Morphine (10 mg IM) is the gold standard to which all other opioids are compared.

Drug
Equivalent dose (mg)
(compared to morphine 10 mg IM)
Duration of action (Hours)
Parenteral
Oral
Strong Opioids Agonists
Morphine 10 60 3-4
Oxycodone 15 30 2-4
Hydromorphone 1.5 7.5 2-4
Anileridine 25 75 2-3
Levorphanol 2 4 4-8
Meperidine 75 300 1-3
Oxymorphone 1.5 5 (rectal) 3-4
Methadone
Heroin 5-8 10-15 3-4
Weak Opioids Agonists
Codeine 120 200 3-4
Propoxyphene 50 100 2-4
Mixed Agonists-Antagonists
Pentazocine 60 180 3-4
Nalbuphine 10 3-6
Butorphanol 2 3-4

Total daily oral morphine equivalent conversion table.

Drug Dose × conversion factor
Pethidine (oral) ×0.125
Pethidine (i.v.) ×0.4
Methadone ×1.5
Oxycodone ×1.5
Buprenorphine ×50
Tramadol x0.20
Codeine ×0.16
Dextropropoxyphene ×0.1
Morphine (i.v.) ×3
Morphine (oral) ×1

 

 

References:

  1. Nissen LM, Tett SE, Cramond T, Williams B, Smith MT. Opioid analgesic prescribing and use – an audit of analgesic prescribing by general practitioners and The Multidisciplinary Pain Centre at Royal Brisbane Hospital. Br J Clin Pharmacol. 2001 Dec;52(6):693-8. [Medline]
  2. Argoff CE, Silvershein DI. A comparison of long- and short-acting opioids for the treatment of chronic noncancer pain: tailoring therapy to meet patient needs. Mayo Clin Proc. 2009 Jul;84(7):602-12. [Medline]

Created: Sep 03, 2009

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