Approximate dose conversions for commonly used opioids (refer to important notes below) | |||||
Morphine | Hydromorphone (Dilaudid) | Oxycodone | Fentanyl transdermal* | ||
IV (mg/day) | Oral (mg/day) | IV (mg/day) | Oral (mg/day) | Oral (mg/day) | Patch (mcg/hour) |
5 | 15 | 0.6 | 3 | 10 | NA |
8.5 | 25 | 1 | 5 | 15 | 12 |
10 | 30 | 1.2 | 6 | 20 | 12 |
17 | 50 | 2 | 10 | 30 | 25 |
33 | 100 | 4 | 20 | 65 | 50 |
50 | 150 | 6 | 30 | 100 | 75 |
67 | 200 | 8 | 40 | 130 | 100 |
83 | 250 | 10 | 50 | 165 | 125 |
100 | 300 | 12 | 60 | 200 | 150 |
117 | 350 | 14 | 70 | 230 | 175 |
133 | 400 | 16 | 80 | 265 | 200 |
150 | 450 | 18 | 90 | 300 | 225 |
167 | 500 | 20 | 100 | 330 | 250 |
183 | 550 | 22 | 110 | 360 | 275 |
200 | 600 | 24 | 120 | 400 | 300 |
Conversion ratios to determine daily total ORAL morphine milligram equivalent (MME) | |||||
Drug | Approximate equivalent oral dose | Approximate equivalent IV or subcutaneous dose | Conversion ratio to determine daily total ORAL morphine milligram equivalent (MME) | ||
Morphine | 30 mg | 10 mg |
| ||
Fentanyl | Not available | 0.1 mg (100 mcg) |
| ||
Hydrocodone | 30 mg | Not available |
| ||
Hydromorphone | 6 mg | 1.2 mg |
| ||
Oxycodone | 20 mg | Not available |
| ||
Oxymorphone | 10 mg | 1 mg |
|
IV: intravenous; mcg: microgram.
* Suggested doses for conversion to transdermal fentanyl from other opioids are less conservative than recommendations in the United States product labeling. The recommendations in this table are based on guidance available at experienced centers.
¶ Wide interpatient variability in response.Courtesy of Kathleen Broglio, DNP, MN, ANP-BC, ACHPN and Russell K Portenoy, MD.
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