Dose conversion between opiates

Change from (total daily dose in mg) Oral codeine Oral dihydrocodeine Oral pethidine Oral morphine Oral dextromoramide Morphine infusion Diamorphine infusion Oral hydromorphone Sublingual buprenorphine Change to (total daily dose in mg)

Oral codeine Oral dihydrocodeine Oral pethidine Divide by 12.5 Divide by 25 Divide by 40 Divide by 40 Divide by 100 Divide by 10 Divide by 20 Divide by 30 Divide by 30 Divide by 75 Divide by 10 Divide by 20 Divide by 30 Divide by 30 Divide by 75 Divide by 2 Divide by 3 Divide by 3 Divide by 7.5 Divide by 50 Divide by 1.5 Divide by 1.5 Divide by 4 Divide by 25 Divide by 1 Divide by 2.5 Divide by 20 Divide by 2.5 Divide by 20 Divide by 7 Multiply by 2 Multiply by 3 Multiply by 1.5 Multiply by 4 Multiply by 1.5 Multiply by 1 Multiply by 7.5 Multiply by 4 Multiply by 2.5 Multiply by 2.5 Multiply by 50 Multiply by 25 Multiply by 20 Multiply by 20 Multiply by 7 Oral morphine

Oral dextromoramide Morphine infusion Diamorphine infusion Oral hydromorphone Sublingual buprenorphine

Intended as a guide only - titrate individually according to pain, response and side effects. Dose conversion from oral morphine to fentanyl transdermal patch 4-hourly morphine dose 5-20mg 15-35mg 40-50mg 55-65mg 70-80mg 85-95mg 24-hourly morphine dose Up to 135mg 135-224mg 225-314mg 315-404mg 405-494mg 495-584mg Fentanyl patch size 25mcg/hr 50 mcg/hr 75mcg/hr 100mcg/hr 125mcg/hr 150mcg/hr

100-110mg 115-125mg 130-140mg 145-155mg 160-170mg 175-185mg

585-674mg 675-764mg 765-854mg 855-944mg 945-1034mg 1035-1124mg

175mcg/hr 200mcg/hr 225mcg/hr 250mcg/hr 275mcg/hr 300mcg/hr