Table 1.
Drug | Equianalgesic Doses (mg) | |
---|---|---|
IV/IM/SC 1 Dose | PO/SL Dose | |
Oxycodone 2 | 10 | 20 |
Hydrocodone 3 | N/A | 25 |
Hydromorphone 4 | 2 | 5 |
Morphine 3 | 10 | 25 |
Fentanyl | 0.15 | N/A |
Oxymorphone | 1 | 10 |
Tapentadol | N/A | 100 |
Tramadol 2 | 100 | 120 |
1 The IM route of administration is not recommended. 2 IV formulation not available in the U.S. at the time of this writing. 3 Oral equianalgesic dose equivalent of 30 mg has been used and is also reasonable, given variations in bioavailability between morphine/hydrocodone and oxycodone (equianalgesic ratio ranges from 1:1 to 2:1 morphine:oxycodone based on individual patient absorption). 4 Previous resources have used a 1:5 ratio for parenteral:oral hydromorphone, but newer data suggest a ratio 1:2.5 is more appropriate. IM = intramuscular, IV = intravenous, mg = milligrams, N/A = not applicable, PO = oral, SC = subcutaneous, SL = sublingual. Adapted from Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing, 2nd Edition, 2019 [71].