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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Archived from the original on December 24, When converting from PCA administration, add the total amount of opioid that the patient received in the last 24 hours, including. As stated above, because equianalgesic tables are inherently inaccurate, the availability of breakthrough doses is paramount.

equianlagesic Because some listed analgesics are prodrugs or have active metabolitesindividual variation in liver enzymes e. Gabapentin Gabapentin enacarbil Pregabalin Ziconotide. Because transdermal fentanyl has a delayed onset and onset of peak activity, consider titrating every 3 days. Equianalgesic dose ratios for opioids. American Society of Health-System Pharmacists.

Carbamazepine Lacosamide Local anesthetics e. The mean terminal plasma elimination half-lives of racemic tramadol and racemic M1 are 6.

Incomplete cross-tolerance can occur due to variability in opioid binding. Home Academy Blog About. In an inpatient setting, rescue doses can be provided IV every minutes. Basal infusion rates are discouraged unless the patient has been taking scheduled opioids for more than one week. These are general guidelines. Values for the potencies represent opioids taken orally unless another route of administration is provided. J Pain Symptom Manage.


An equianalgesic or opioid chart is a conversion chart that lists equivalent doses of analgesics drugs used to relieve pain. The equiwnalgesic elimination half-life of racemic tramadol increased from approximately six hours to seven hours upon multiple dosing.

Archived from the original on This page was last edited on 30 Novemberat Continue looking for other causes of sedation and respiratory depression. Retrieved from ” https: If given IV, each 0. Equianalgesic conversions used in this calculator are based on the American Pain Society guidelines and critical review papers regarding equianalgesic dosing.

Calcium blockers Gabapentin Gabapentin enacarbil Pregabalin Ziconotide. American Pain Society Interactions with other drugsfood and drinkand other factors may increase or decrease the dquianalgesic of certain analgesics and alter their half-life.

Depending on amount and type of opioid given and time interval since last opioid administration, the duration of action of some opioids may exceed that of naloxone.

Equianalgesic Chart (Changes in italics)

J Am Osteopath Assoc. Patient is receiving a total of 5 mg of parenteral hydromorphone in a hour period via a PCA pump. Repeated equianalesic of a medication is also different from single dosing, as many drugs have active metabolites that can build up in the body.

The amount of opioid required to achieve comfort varies from patient to patient. Tolerancesensitizationcross-tolerancemetabolismand hyperalgesia may be equianalgesuc factors in some individuals.


Lower doses should be used initially, then titrated up to achieve pain relief. These include practical considerations such as lower cost or unavailability of a drug at the patient’s preferred pharmacy, or medical reasons such as lack of effectiveness of the current drug or to minimize adverse effects.

Pharmacologic treatment of cancer pain. MOR is the most commonly used opioid analgesic for pain relief, and its oral daily dose 20 to mg is relatively high Equianalgesic tables are available in different formats, such as pocket-sized cards for ease of reference. These variables are rarely included in equianalgesic charts.

From Wikipedia, the free eqyianalgesic. N Engl J Med.

Equivalent Opioid Calculator

Am J Hosp Pharm. Contact the Pain Service for other alternatives. Methadone acute [17] [18]. A Guide for Effective Dosing. Agonists abridged; see here for a full list: There is an overall lack of data regarding most equianalgesic conversions, and there is a significant degree of interpatient variability. Methadone is different from most opioids considering its potency can vary depending on how long it is taken.

American Society of Health-System Pharmacists. Retrieved December 28, Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain.