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Approach to opioid rotation in the neonate.
| Current agent | Arbitrary maximum dose | New agent | Dose calculation |
|---|---|---|---|
| Fentanyl | 5 mcg/kg/h | Morphine (mcg/kg/hr) | Multiply fentanyl dose by 10–20 and reduce by ~25% for cross tolerance |
| Morphine | 200 mcg/kg/h | Hydromorphone (mcg/kg/hr) | Divide morphine dose by 7 and reduce by ~25% for cross tolerance |
