EQUIANALGESIC CHART

DRUG DOSAGE FORM / STRENGTHS DURATION EQUIVALENCE
IM/SC/IV Morphine Oral
Morphine
Morphine Immediate Release Tablets   10 mg 30 mg
   MSIR - 15, 30 mg q 3-6 hrs
Sustained Release Tablets
   MS Contin - 15, 30, 60, 100, 200 mg (1) q 12 hrs
   Kadian - 20, 30, 50, 60, 100 mg (1,2) q 24 hrs
   Oramorph SR - 15, 30, 60, 100 mg (1) q 12 hrs
Oral Liquid
   MSIR Oral Solution - 2mg/ml, 4mg/ml q 3-6 hrs
   MSIR Oral Concentrate - 20mg/ml q 3-6 hrs
   Roxanol Concentrate - 20mg/ml q 3-6 hrs
Suppository
     Rectal Morphine Sulfat (RMS) - 5, 10,
   20, 30 mg

q 4 hrs
     
Hydromorphone Tablets 1.5 mg 7.5 mg
   Dilaudid - 2, 4, 8 mg q 3-6 hrs
Liquid
   Dilaudid - 2 mg/ml q 3-6 hrs
   Dilaudid - 10 mg/ml q 3-6 hrs
Suppository
     Dilaudid - 3 mg q 6-8 hrs    
Oxycodone Immediate Release Tablets     20-30 mg
   Oxy IR - 5 mg q 3-4 hrs
   Roxicodone - 5 mg q 3-4 hrs
   Oxycodone/Acetiminophen (3)
   Percocet-5/325,7.5/500,10/500 mg (3) q 3-4 hrs
   Roxicet-5/325, 5/500 mg (3) q 3-4 hrs
Sustained Release Tablets
   Oxycontin - 10, 20, 40, 80 mg q 8-12hrs
Liquid
   Roxicodone - 1mg/ml, 20mg/ml q 3-4 hrs
     OxyFAST - 20mg/ml q 3-4 hrs    
Fentanyl
Transdermal
Skin Patch (4) 100 mcg patch q2-3 days = 66 mg IV Morphine q24 hrs
OR
2.7 IV Morphine q1 hr
100 mcg patch q2-3 days = 200 mg Oral Morphine q24 hrs
OR
33 mg Oral
Morphine q4 hrs
     Duragesic - 25, 50, 75, 100 mcg/hr q 48-72 hrs
Fentanyl
Transmucosal
Oral Lozenge (5)          
     Actiq - 200, 400, 600, 800, 1200, 1600 mcg            
Methadone (6) Tablet            
     Dolophine - 5,10 mg q 4-12 hrs 10 mg acute
2-4 mg chronic
20 mg acute
2-4 mg chronic
  Liquid      
     Generic Methadone - 1,2 mg/m q 4-12 hrs 1-2 mg 2.5-5 mg
Hydrocodone Hydrocodone/Acetaminophen Tablets (3)     Vicodin
5mg/500 mg=
9mg Oral
Morphine
     Vicodin -5/500 mg q 4-6 hrs  
     Vicodin ES - 7.5/750 mg q 4-6 hrs  
     Lorcet or Vicodin HP - 10 mg/650 mg q 4-6 hrs  
     Lortab - 2.5/500 mg, 5/500 mg,
   7.5/500 mg, 10/500 mg
q 4-6 hrs  
     Norco - 5/325 mg, 7.5/325 mg, 10/325 mg q 4-6 hrs  
  Hydrocodone/Ibuprofen    
     Vicoprophen - 7.5/200 mg q 4-6 hrs  

1.  Do not crush or chew tablets

2.  Capsules may be opened and granules spronkled on food or placed in NG tube

3.  Dose in 24 hrs limited to maximum acetaminophen 4000 mg

4.  Do not cut patch.  Must be in contact with skin

5.  Onset 5 minutes; not recommended for opioid naive patients

6.  Accumulates with repeated dosing, requiring decreases in dose size and frequency, especially on days 2-5

7.  May wish to titrate on q 8 hr schedule

NOTES:
- Butorphanol (Stadol), Meperidine (Demerol), Nalbuphine HCL (Nubain), Pentazocine (Talwin), and Propoxyphene (Darvon, Darvocet) are not recommended for the management of cancer pain
 

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©2002 Delaware Pain Initiative