Opiate equavalencies
| Drug | IV (mg) | PO (mg) | frequency (hrs) |
| morphine | 1 | 3 | 3-4 |
| dilaudid | 0.2 | 0.6 | 12-24 |
| fentanyl | 10 mcg | - | 1 |
| methadone | - | 1 | 8-12 |
| hydrocodone | - | 3 | 3-4 |
| oxycodone | - | 2 | 3-4 |
rule of thumb IV:PO = 1:3
Converting to Duragesic (fentanyl patch)
Determine IV morphine requirement in mg per 24 hours and select the corresponding mcg/hr fentalyl dose patch
| IV morphine (mg/24h) | duragesic (mcg/h) |
| 8-22 | 25 |
| 23-37 | 50 |
| 38-52 | 75 |
| 63-67 | 100 |
| 68-82 | 125 |
| 83-97 | 150 |
- Change patch every 72 hours.
- To titrate: Use prn narcotic, esp during first 12 hours. Increase patch dose based on additional narcotic requirement.
- Remove patch 6-12 h before switching to another long-acting opioid
- Caution: hot showers, hot weather, high-fever, and sweating may increase release.