Opioid pain medications: Difference between revisions
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! SC/IV |
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| Morphine |
| [[Morphine]] |
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| 10mg |
| 10mg |
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| 5mg |
| 5mg |
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| Codeine |
| [[Codeine]] |
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| 100mg |
| 100mg |
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| — |
| — |
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| Hydromorphone |
| [[Hydromorphone]] |
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| 2mg |
| 2mg |
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| 1mg |
| 1mg |
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| Oxycodone |
| [[Oxycodone]] |
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| 5-7.5mg |
| 5-7.5mg |
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| — |
| — |
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| Methadone |
| [[Methadone]] |
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| 1mg |
| 1mg |
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| — |
| — |
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| Fentanyl |
| [[Fentanyl]] |
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| — |
| — |
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| 50mcg |
| 50mcg |
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Revision as of 14:04, 5 July 2020
Opioid equivalence doses
| Opioid | PO | SC/IV |
|---|---|---|
| Morphine | 10mg | 5mg |
| Codeine | 100mg | — |
| Hydromorphone | 2mg | 1mg |
| Oxycodone | 5-7.5mg | — |
| Methadone | 1mg | — |
| Fentanyl | — | 50mcg |
Starting doses
- Codeine: 15mg po q4h + 15mg po q1-2h prn
- Morphine: 5mg po q4h + 5mg po q1-2h prn
- Hydromorphone: 1mg po q4h + 1mg po q1-2h prn
- Start lower with severe frailty, COPD, and CHF
- Start with short-acting and stabilize pain before transitioning to long-acting
- Also consider:
- Senna/lactulose/PEG (not colace) for constipation
- Metoclopramide/domperidone for nausea
Breakthrough dosing
- Rule out end-of-dose failure
- Use short-acting formulation of background opioid
- Start as 10% of total daily dose, then titrate 5-20%
