Algos
Rapid Opiate Dose Equivalence Information
OPIATE CONVERSION CALCULATION TABLE: AVERAGE DOSES.
ACTUAL DOSAGE REQUIREMENTS WILL VARY WITH
METABOLISM OF THE SPECIFIC DRUG AND THE SIDE EFFECT
PROFILE TOLERATED. (Always start with a lower dose than
calculated) Hepatic and renal disease may require much lower doses.
Examples:
MS 100mcg/day=Oxycodone 50mg/day=Methadone 30mg/day = Hydrocodone 60mg/day=Hydromorphone 12mg/day=Levorphanol 6mg/day
8mg levorphanol =65mg oxycodone = 130mg morphine = 50mg methadone = 70mg hydrocodone = 16mg dilaudid=25+12mcg Duragesic
Half Lives of Opiates:
Hydrocodone 3.3-4.5 hrs Hydromorphone 2-3 hrs oxycodone 3.5-5.6 hrs propoxyphene 6-12 hrs
Levorphanol 12-16 hrs Methadone 15-30 hrs morphine 1-7 hrs
References: oxycodone: Ther Drug Monit. 1992 Dec;14(6):479-84, Clin Pharmacol Ther. 1992 Nov;52(5):487-95
morphine: Clin Pharmacokinet. 1986 Mar-Apr;11(2):87-106
hydrocodone: J Chromatogr. 1977 Jan 11;130:243-9
Care must be taken with opiates in patients with hepatic disease (esp. morphine,
buprenorphine) as the terminal half lives increase with morphine by several hundred percent
while buprenorphine may primarily cause hepatic dysfunction (Acta Gastroenterol Belg. 2005
Jan-Mar;68(1):81-5, Eur J Gastroenterol Hepatol. 2004 Oct;16(10):1033-7).
Drug Below in mg
x multiplier = drug to
the right in mg
|
=Oxycodone
|
=Morphine
|
=Methadone
|
=Hydrocodone
|
=Hydromorphone
|
= Levorphanol
|
=Fentanyl TD mcg/hr
|
Morphine
|
0.5
|
1
|
0.33
|
0.6
|
0.12
|
0.06
|
0.25
|
Oxycodone
|
1
|
2
|
0.67
|
1.1
|
0.25
|
0.12
|
0.5
|
Methadone
|
1.5
|
3
|
1
|
1.65
|
0.37
|
0.2
|
0.8
|
Hydrocodone
|
0.9
|
1.8
|
0.6
|
1
|
0.2
|
0.1
|
0.45
|
Hydromorphone
|
4
|
8
|
3
|
4.5
|
1
|
0.5
|
2
|
Levorphanol
|
8
|
16
|
6
|
9
|
2
|
1
|
4
|
Fentanyl TD
mcg/hr
(mcg to mg conversion)
|
2
|
4
|
1.5
|
2.2
|
0.5
|
0.25
|
1
|
|