Oral opioid analgesic conversion table based on oral dosing for chronic noncancer pain: A) Equivalence to 30 mg of oral morphine; B) Equivalence between oral morphine and transdermal fentanyl.
| A) | |||
|---|---|---|---|
| OPIOID | EQUIVALENCE TO 30 MG ORAL MORPHINE | TO CONVERT TO ORAL MORPHINE EQUIVALENT MULTIPLY BY ... | TO CONVERT FROM ORAL MORPHINE MULTIPLY BY ... |
| Morphine | 30 mg | 1 | 1 |
| Codeine | 200 mg | 0.15 | 6.67 |
| Oxycodone | 20 mg | 1.5 | 0.667 |
| Hydromorphone | 6 mg | 5 | 0.2 |
| Meperidine | 300 mg | 0.1 | 10 |
| Methadone and tramadol | Morphine dose equivalence not reliably established | ||
| B) TRANSDERMAL FENTANYL* | MORPHINE |
|---|---|
| 25 μg/h | 60–134 mg |
| 37 μg/h | 135–179 mg |
| 50 μg/h | 180–224 mg |
| 62 μg/h | 225–269 mg |
| 75 μg/h | 270–314 mg |
| 87 μg/h | 315–359 mg |
| 100 μg/h | 360–404 mg |
↵* Formulations include 12-, 25-, 50-, 75-, and 100-μg/h patches, but the 12-μg/h patch is generally used for dose adjustment rather than initiation of fentanyl treatment.
Adapted from the National Opioid Use Guideline Group.5 Data from the Compendium of Pharmaceutical and Specialties27 and Pereira et al.49 Wide ranges have been reported in the literature. These equivalences refer to analgesic strength of oral opioids and not psychoactive effects or effectiveness in relieving withdrawal symptoms.