Shoutout to RTO for this tidbit he learned from palliative care on a quicker way to do opioid conversions. Thought I’d share it with you all!

Have you had patients who are on opiates at home, need pain relief, not exactly sure how much they may take at home or where to start? Just confused in general about equivalents and because charts tend to look like this?

Try this: Clockwise (ish) count from 2. You multiple in the direction of the arrow.

Examples: 1 mg IV dilaudid is about 6.6 mg IV morphine. 1 mg IV dilaudid is about 5 mg PO dilaudid. 1 mg IV dilaudid is about 20 mg PO morphine. 1 mg IV morphine is about 2 mg oxycodone PO. Fentanyl is the confusing one because we’re generally used to mcg. The 7 is there to help you remember the range is from 6.6-7.5 and is easier than decimals and larger numbers, but really 1 mg IV dilaudid is about 0.07 mg or 70 mcg IV fentanyl.

Caveat: Equivalences are not a perfect science, especially the 3:1 morphine conversion. The dosages affect different people differently so be judicious with your initial dosages of medications to gauge how people will react and to avoid toxicity.

June 2022
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