- Table 3 provides an equianalgesic conversion table comparing various opioid medications including morphine, hydromorphone, methadone, fentanyl, meperidine, oxycodone, codeine, and propoxyphene.
- It lists the equivalent doses of each medication administered via different routes such as orally, intravenously, and intramuscularly. It also provides information on peak effect, duration of action, and recommended starting doses for both adults and pediatrics.
- The table aims to guide practitioners in determining approximately equivalent analgesic doses of different opioid medications to achieve similar pain relief.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online from Scribd
- Table 3 provides an equianalgesic conversion table comparing various opioid medications including morphine, hydromorphone, methadone, fentanyl, meperidine, oxycodone, codeine, and propoxyphene.
- It lists the equivalent doses of each medication administered via different routes such as orally, intravenously, and intramuscularly. It also provides information on peak effect, duration of action, and recommended starting doses for both adults and pediatrics.
- The table aims to guide practitioners in determining approximately equivalent analgesic doses of different opioid medications to achieve similar pain relief.
- Table 3 provides an equianalgesic conversion table comparing various opioid medications including morphine, hydromorphone, methadone, fentanyl, meperidine, oxycodone, codeine, and propoxyphene.
- It lists the equivalent doses of each medication administered via different routes such as orally, intravenously, and intramuscularly. It also provides information on peak effect, duration of action, and recommended starting doses for both adults and pediatrics.
- The table aims to guide practitioners in determining approximately equivalent analgesic doses of different opioid medications to achieve similar pain relief.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online from Scribd
- Table 3 provides an equianalgesic conversion table comparing various opioid medications including morphine, hydromorphone, methadone, fentanyl, meperidine, oxycodone, codeine, and propoxyphene.
- It lists the equivalent doses of each medication administered via different routes such as orally, intravenously, and intramuscularly. It also provides information on peak effect, duration of action, and recommended starting doses for both adults and pediatrics.
- The table aims to guide practitioners in determining approximately equivalent analgesic doses of different opioid medications to achieve similar pain relief.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online from Scribd
Download as doc, pdf, or txt
You are on page 1/ 1
Table 3: OPIOID EQUIANALGESIC CONVERSION TABLE 1
Equianalgesic Dose Peak Duration RECOMMENDED STARTING DOSE Comments Medication IM2/IV1 PO1 Effect of Action {How supplied} mg mg (min) (hr) PEDIATRICS ADULTS IV Push: 10 - 20 IV Push: 1 IV: See Footnote 3 IV: 0.05-0.1mg/kg q 1-3h Morphine 10 30 PO: 45 - 60 PO/IM2/SubQ: 3 – 6 PO: 30mg q 3-4h PO: 0.3-0.6mg/kg q3-4h IM2/SubQ: 30 IM2/SubQ: 10mg q 3-4h Morphine sustained release --- 30 PO: 1.5 – 2 h 8 – 12 Used around the clock for recurrent, continuing pain after pain is controlled on short-acting analgesic. Perform (MS Contin) equianalgesic conversion from short-acting to long acting analgesic. Do not crush/cut/chew. May be given PR, use oral equivalent. Hydromorphone IV Push: 10 - 20 IV Push: 1 IV: See Footnote3 IV: 0.01-0.04mg/kg q 1-3h (Dilaudid) 1.5 7.5 PO: 45 - 60 PO/IM2/SubQ: 3 - 4 PO: 6mg q 3-4h PO: 0.05-0.2mg/kg q 3-4h IM2/SubQ: 30 IM2/SubQ: 1.5mg q 3-4h Methadone IV over 20 min: 30 - 60 IV over 20 min/PO/IM2: IV over 20 min: 10mg q 6-12h IV over 20 min: 0.1mg/kg q 6-8h Prolonged elimination half-life (15-36 hr), (Dolophine) 10 20 PO: 2 – 4 hr 4-6 PO: 20mg q 6-12h PO: 0.2 mg/kg q 6-8h drug may accumulate. Analgesic duration 6-8 hours Fentanyl4 100 20 – 30 IV Push: 1 - 3 IV: 25-50mcg q 30min-1h IV: 0.5-1mcg/kg q 30 min-1h Highly potent; may produce respiratory (Sublimaze) (mcg) --- depression, apnea, or stiff chest. When used IVP, administer in the ICU or use careful observation and pulse oximetry. Meperidine 100 300 NR IV Push: 10 - 20 IV Push: 1 IV: See Footnote3 IV: Not recommended Max dose is 1Gm/24h and 2-3Gm/7 days or (Demerol) NR = Not PO: 45 - 60 PO/IM1/SubQ: 2 - 4 PO: Not recommended PO: 0.75mg/kg q 6-8h less. recommende d IM1/SubQ: 30 IM1/SubQ: 100mg q 3h Toxic metabolite normeperidine may cause seizures and agitation Oxycodone Liquid solution available - comes as 5mg/ml; {Roxicodone (5mg/tab), --- 20 45 - 60 3-4 PO: 10mg q 3-4h PO: 0.15-0.2ml/kg q 3-4h alcohol free. Solution (5mg/5ml)} Oxycodone sustained --- 15 60 12 PO: 10mg q 12 h Not recommended in children Used around the clock for recurrent, release (OxyContin) < 10 years old continuing pain after pain is controlled on short-acting analgesic. Do not crush/cut/chew. Oxycodone/ Acetaminophen Liquid solution available - comes as {Percocet 1 tab or Roxicet 30 45 - 60 3-4 PO: 1-2 tabs q 4h PO: 0.15-0.2ml/kg q 3-4h oxycodone 5mg/acetaminophen 325mg per 5ml (5mg/325mg)} --- 5ml; alcohol free. Consider acetaminophen upper dose limits5 Suggested maximum single dose = 65mg. Codeine --- 200 NR 45 - 60 3-6 PO: 60mg q 3-4h PO: 0.5-1mg/kg q 3-4h Expect increased side effects with doses >65mg.
Codeine/ Liquid elixir available - comes as 12mg
Acetaminophen --- 135 NR 45 - 60 3-6 PO: 1 -2 tabs q4h PO: 0.4ml/kg q 4h codeine/120mg acetaminophen per 5ml; {Tylenol #3 1 tab contains alcohol. (30mg/325mg)} Consider acetaminophen upper dose limits5 Propoxyphene HCl/ Toxic metabolite accumulates but generally Acetaminophen --- 200 NR 45 - 60 3-6 PO: 1 tab q 4h PO: Not recommended clinically significant only in the elderly. {Wygesic 1 tab Weak opioid: Propoxyphene HCl 65mg = (65mg/650mg)} Acetaminophen 650mg Consider acetaminophen upper dose limits5 1 All conversions are considered equianalgesic to 10 mg parenteral morphine. When performing an equianalgesic conversion, consider reducing dose by 25% due to incomplete cross-tolerance. 2 Least desired route 3 For IV push dose, divide IM/SubQ dose by 3 and administer IV push over 2-3 min q 1 hour, or administer via continuous infusion 4 Fentanyl Patch (Duragesic): Used around the clock for recurrent, continuing pain after pain is controlled on short-acting analgesic. Perform equianalgesic conversion from short-acting to long acting analgesic. Fentanyl patch 25 mcg/hr is approximately equivalent to 45-134 mg. PO morphine/day. Peak effect 18-24 hours after initial application, duration of action 3 days. Do not cut patch. Not recommended for pediatric patients <20kg. 5 Acetaminophen upper dose limits: Peds 90 mg/kg/day, Adult 3-4 Gm/day. /var/www/apps/scribd/scribd/tmp/scratch2/10058086.doc 6/11/02
