These bidirectional differences are not captured in a traditional equianalgesic table.,; Dose-dependent conversions: The conversion ratio of. Opiate Equianalgesic Dosing Chart. Pharmacy & Therapeutics Committee. Note: Published tables vary in the suggest algesic to morphine. Clinical response is. TABLE 1: OPIOID EQUIANALGESIC TABLE. NB: It is important to recognize the limitations of opioid equianalgesic tables. Equianalgesic doses have been.

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Incomplete cross-tolerance is a reduction in equianalgesic dose when changing from one opioid to another.

Equianalgesic – Wikipedia

Equianalgesic conversions used in this equianalgezic are based on the American Pain Society guidelines and critical review papers regarding equianalgesic dosing. There is an overall lack of data regarding most equianalgesic conversions, and there is a significant degree of interpatient variability.

For this reason, reasonable clinical judgment, breakthrough rescue opioid regimens, and dose titration are of paramount importance. As a clinician, it is important to note that there are significant limitations to equianalgesic qeuianalgesic and tables.


While these equianalgesic tables are current the “best” solution, their limitations should be emphasized:. When switching between opioids, equianalgesic conversions may overestimate the potency of the new opioid due to incomplete cross-tolerance.

Incomplete cross-tolerance can occur due to variability in opioid binding. There is no evidence-based recommendation for an appropriate reduction.

In patients receiving long-acting opioid formulations SRtransdermala “rescue” dose for breakthrough pain is recommended. In an inpatient setting, rescue doses can be provided IV every minutes. Oral rescue doses can be offered as needed over the normal dosing interval of the equianallgesic typically every 4 hours.

Equivalent Opioid Calculator

As stated above, because equianalgesic tables are inherently inaccurate, the availability of breakthrough doses is paramount. Because equianalgesic tables are inherently inaccurate, dose titration to optimal effect is equianalvesic. Because transdermal fentanyl has a delayed onset and onset of peak activity, consider titrating every 3 days. Press ‘Calculate’ to view calculation results.

Janssen Pharmaceuticals, Inc; Practice guidelines for transdermal opioids in malignant pain. An alternative algorithm for dosing transdermal fentanyl for cancer-related pain. Principles of analgesic use in the treatment of acute pain and cancer pain.

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American Pain Society; Accuracy in equianalgesic dosing. J Pain Symptom Manage.

Equianalgesic dose ratios for opioids. Opioid conversions in acute care.

Opioid Equianalgesic Doses – MPR

Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. Pharmacologic treatment of cancer pain. N Engl J Med. Management of cancer pain: Agency for Health Care Policy and Research. Am J Hosp Pharm. Opioid Opiate Equianalgesia Conversion Calculator. Updated March 12, Accessed December 31, Home Academy Blog About.