|
All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
judgement. Neither GlobalRPh Inc. nor any other party involved in the
preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
PLEASE READ THE DISCLAIMER
CAREFULLY
BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU
AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
Read
the disclaimer
|
|
The
narcotic analgesic converter is based on the following table:
Note: levorphanol,
oxymorphone, and propoxyphene have been eliminated from the
calculator.
|
| Drug |
Duration |
Half-life |
Route |
Equianalgesic
Dosage |
|
Codeine
|
46 h
|
3 h
|
IM/IV/SC
|
120 mg
|
|
|
|
|
PO
|
200 mg
|
|
Fentanyl
|
12 h
|
1.56 h
|
IM/IV
|
0.1
- 0.2 mg
|
|
Hydrocodone
|
48 h
|
3.34.5 h
|
PO
|
20-30 mg
|
|
Hydromorphone
|
45 h
|
23 h
|
IM/IV/SC
|
1.31.5
mg
|
|
|
|
|
PO
|
7.5 mg
|
|
Levorphanol
|
68 h
|
1216 h
|
IM/IV/SC
|
2 mg
|
|
|
|
|
PO
|
4 mg
|
|
Meperidineζ
|
24 h
|
34 h
|
IM/IV/SC
|
75 mg
|
|
|
|
|
PO
|
300 mg
|
|
Methadone
|
46 h
|
1530 h
|
IM/IV/SC
|
1-10 mg§ Medline
Short term: 5-10mg
Chronic use: 1-4 mg
(2 mg)
|
|
|
|
|
PO
|
2 - 20 mg§
Medline
Short term use: 20 mg
Chronic dosing: 2-4 mg
(3mg)
|
|
Morphine
|
36 h
|
1.53 h
|
IM/IV/SC
|
10 mg
|
|
|
|
|
PO
|
3060 mg#
|
|
Oxycodone
|
46 h
|
NA
|
PO
|
15-30 mg
(20 mg)
|
|
Oxymorphone
|
36 h
|
NA
|
IM/IV/SC
|
1 mg
|
| Important
Update: Opana and Opana ER (oxymorphone
immediate release and oxymorphone extended release tablets)
have been approved by the FDA. |
|
PO
|
10 mg
|
|
Propoxyphene
|
46 h
|
612 h
|
PO
|
130-200 mg
*
|
*
|
Propoxyphene HCL:
130mg; Napsylate: 200mg. Not recommended for chronic pain
management and
therefore not available in program above. |
| # |
Acute dosing
(opiate naive):
60mg. Chronic dosing: 30 mg. |
| §: |
Many equianalgesic
tables underestimate methadone potency - more studies are
needed. Parenteral: Program utilizes 10mg for short-term
dosing and 2 mg for chronic dosing. Oral: Program
utilizes 20mg for short-term dosing and 3 mg for chronic dosing. |
| ζ |
Meperidine should be used for acute dosing only
and not used for chronic pain management (meperidine has a short
half-life and a toxic metabolite: normeperidine). Its use should also be
avoided in patients with renal insufficiency, CHF, hepatic insufficiency,
and the elderly because of the potential for toxicity due to
accumulation of the metabolite normeperidine. Seizures, confusion,
tremors, or mood alterations may be seen.
|
|
|
References
Completed
Medline Search |
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| 2. |
American Pain Society. Principles
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| 3. |
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JH, Abram S, Schlicht C.Accuracy in equianalgesic dosing. conversion dilemmas. J Pain Symptom Manage 2001 May;21(5):397-406 |
| 4. |
Bruera E, Sweeney C.Methadone
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| 5. |
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C.S. et al.
"Pain and Its Treatment in Outpatients with Metastatic
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| 6. |
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| 11. |
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|
| 14. |
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| 15. |
Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E.Equianalgesic dose ratios for
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| 16. |
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|
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