Table of Contents

EQUIANALGESIC DOSING FOR MANAGEMENT OF ACUTE OR CHRONIC PAIN

(Equivalent to Morphine 10mg IM/SC/IV)

Drug IM/SC/IV (mg) PO/PR/SL (mg) Duration of Action (hrs)
AGONISTS
Morphine 10 20-30 3-4
Codeine 120-130 200 3-4
Hydromorphone 2 4 3-4
Oxycodone - 15-20 3-4
Meperidine* 75-100 300 3
 Fentanyl 100mcg (0.1mg) - 2-3
 Fentanyl Transdermal  25mcg/hr = 30- 67 mg IM/IV morphine/24hrs  25mcg/hr = 60-134mg PO morphine/24hrs 3 days
 Methadone - Depends on morphine dose (see below)** >6
 Propoxyphene - 260-390 4-6
AGONIST-ANTAGONISTS
 Pentazocine* 60 180 3

* not recommended for chronic pain management

**Daily chronic oral morphine equivalent

Conversion ratio morphine:methadone

< 100 mg

3:1

100-300mg

5:1

300-600mg

10:1

600-800mg

12:1

800-1000mg

15:1

> 1000 mg

20:1

**Caveat: Equivalence of methadone to morphine may vary considerably from one individual to another. Use conversion table with caution. (From BC College of Physicians and Surgeons)