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01 Comparison of Fentanyl With Morphine
01 Comparison of Fentanyl With Morphine
A PUBLICATION OF THE PHARMACY AND THERAPEUTICS COMMITTEE (P&T) AND THE DEPARTMENT OF PHARMACY
Hydromorphone Fentanyl
Morphine
(Dilaudid®) (Sublimaze®)
Gold standard
opioid analgesic;
Semi-synthetic
Description naturally occurring 100% synthetic
morphine derivative
alkaloid derived
from opium
Hydrophilic but less Highly lipophilic;
Highly hydrophilic;
Properties so than morphine; strongly
strongly lipophobic
moderately lipophilic hydrophobic
Onset Time
5 minutes 3 minutes < 1 minute
(IV push)
Peak Effect
10 minutes 8 minutes 2 – 3 minutes
(IV push)
Duration of
Action 1 – 4 hours 1 – 4 hours 30 – 45 minutes
(IV push)
Dose 0.05 – 0.1 mg/kg, 0.01 – 0.02 mg/kg, 0.25 – 0.5 mcg/kg,
(IV push) repeat to effect repeat to effect repeat to effect
Equianalgesic
Dosing for Acute 10 mg 2 mg 100 mcg
Administration
Sedation Moderate Mild Minimal to None
Morphine-6-
glucuronide:
more potent
Active analgesic and
None None
Metabolites respiratory
depressant than
morphine;
renal excretion
Apnea at
Therapeutic Low Low High
Doses
Chest Wall
None None High
Rigidity
Addiction
Low Low to Moderate High
Potential
Reference
"Postoperative Pain Management" editors F. Michael Ferrante and Timothy R. VadeBoncouer; chapter 8, “Opioids" by F.
Michael Ferrante, pages 145-209.
Contributors: Lynda Wells, MD, Department of Anesthesia; Nancy Ray, RN CMA, CNO/Associate Administrator, Nursing Service; Pamela Maxwell,
PharmD; RCGarcia RPh, Department of Pharmacy
Reviewers: James Rogers, MD; VP Quality & Cost Improvement; Medical Director, Pain Center; P&T members
Editors: Alexander Shepherd MD, Chairman, P&T Committee, Yolanda Laurel, Director of Pharmacy Services, University Health System.