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Opioid Conversion Tables

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Morphine
IV/Subcutaneous/IM (mg)
10Morphine
PO/Rectal (mg)
30Morphine
Ratio IV : PO
1 : 3Morphine
Duration of effect
4 hoursMorphine
Long Acting Morphine
PO/Rectal (mg)
30Long Acting Morphine
Duration of effect
12 hoursLong Acting Morphine
HYDROcodone (Vicodin,Lortab)
PO/Rectal (mg)
30HYDROcodone (Vicodin,Lortab)
Duration of effect
4 hoursHYDROcodone (Vicodin,Lortab)
OXYcodone
PO/Rectal (mg)
20OXYcodone
Duration of effect
4 hoursOXYcodone
Long Acting OXYcodone
PO/Rectal (mg)
20Long Acting OXYcodone
Duration of effect
12 hoursLong Acting OXYcodone
OXYmorphone (Opana)
IV/Subcutaneous/IM (mg)
1OXYmorphone (Opana)
PO/Rectal (mg)
10OXYmorphone (Opana)
Ratio IV : PO
1 : 10OXYmorphone (Opana)
Duration of effect
4 hoursOXYmorphone (Opana)
Long Acting OXYmorphone
PO/Rectal (mg)
10Long Acting OXYmorphone
Duration of effect
12 hoursLong Acting OXYmorphone
HYDROmorphone (Dilaudid)
IV/Subcutaneous/IM (mg)
1.5HYDROmorphone (Dilaudid)
PO/Rectal (mg)
7.5HYDROmorphone (Dilaudid)
Ratio IV : PO
1 : 5HYDROmorphone (Dilaudid)
Duration of effect
4 hoursHYDROmorphone (Dilaudid)
Fentanyl (See note 3)
See package insert for conversions involving fentanyl patches.
Methadone (See note 4)
Methadone has a complex pharmacokinetic and pharmacodynamic profile that makes equianalgesic dosing particularly difficult. Consult with an experienced clinician before initiating or adjusting the dose of methadone.
Codeine
IV/Subcutaneous/IM (mg)
130Codeine
PO/Rectal (mg)
200Codeine
Ratio IV : PO
1 : 1.5Codeine
Duration of effect
4 hoursCodeine
Note
If converting between opioids when pain is well controlled, decrease the dose of the new opioid by 25-50% to allow for incomplete cross-tolerance. Be prepared to titrate up rapidly for analgesia in the first 24 hrs. If pain is not controlled, you may choose not to decrease the dose.
Intramuscular administration is discouraged because subcutaneous administration is as effective and less painful.