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Approximate oral equianalgesic doses for commonly used opioids

Approximate oral equianalgesic doses for commonly used opioids
Drug Approximate equivalent doses
(oral immediate-release preparations)		 Approximate equianalgesic dose ratio
(morphine:alternate opioid)
Codeine* 200 mg 0.15:1
Fentanyl No oral equivalent  
Hydrocodone 30 mg 1:1
Hydromorphone 6 mg 5:1
Morphine 30 mg 1:1 (reference standard)
Oxycodone 20 mg 1.5:1
Oxymorphone 10 mg 3:1
Tapentadol 75 mg 0.4:1
Tramadol 150 mg 0.2:1
Equianalgesic conversions serve only as a general guide to estimate opioid dose equivalents. For a review of multiple factors that must be considered for safely individualizing conversion of opioid analgesia, refer to UpToDate topics on the use of opioids for acute and chronic pain.
* Generally not recommended due to high variability in response.
Adapted from: Dowell D, Ragan KR, Jones CM, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain – United States, 2022. MMWR Recomm Rep 2022; 71:1.
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