Strong Opioid Conversion Guide

From WardWiki - Foundation Doctor Helper

Slow release forms

MST	MXL	Oxycontin	IV/SC Morphine	SC Diamorphine	Fentanyl patch
30mg BD	60mg OD	10/20mg BD	30mg/24hrs	20mg/24hrs	25mcg/72hrs
60mg BD	120mg OD	30mg BD	60mg/24hrs	40mg/24hrs	25mcg/72hrs
90mg BD	180mg OD	40/50mg BD	90mg/24hrs	60mg/24hrs	50mcg/72hrs
120mg BD	240mg OD	60mg BD	120mg/24hrs	80mg/24hrs	75mcg/72hrs
150mg BD	300mg OD	70/80mg BD	150mg/24hrs	100mg/24hrs	75mcg/72hrs
180mg BD	360mg OD	90mg BD	180mg/24hrs	120mg/24hrs	100mcg/72hrs
210mg BD	420mg OD	100/110mg BD	210mg/24hrs	140mg/24hrs	125mcg/72hrs
240mg BD	480mg OD	120mg BD	240mg/24hrs	160mg/24hrs	125mcg/72hrs

Immediate release forms (starting dose show) - 4 hrly PRN (doses). PRN Analgesia should be 1/6 of the daily dose and given 1-2 hourly PRN

Oramorph	Sevredol	Oxynorm	SC Diamorphine	SC Morphine
10mg/5mls	10mg	5mg/5mls	2.5-5mg	2.5-5mg

Above conversions are intended as a guide only. For further advice contact your local pharmacist or Palliative Care team.

Always prescribe a laxative when prescribing any opioid. Antiemetics may also be necessary when opioids are first used or when the dose is significantly increased.

Pleas note that Morphine is the strong opioid of choice. Oxycodone is approximately twice as strong as Morphine. Divide the total 24 hour dose of oral Morphine by 3 when converting to SC Diamorphine.

Source

http://ceaccp.oxfordjournals.org/content/5/6/203.full.pdf