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:
- 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]
- 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