Updated in 2018, some clinicians are unaware of the changes to the opioid conversion tables.
When converting between opioids, it is important to remember the following steps:
Determine the patient’s level of pain and current response to therapy.
Calculate current opioid requirement.
Convert the opioid using table above.
ASSESS! Combine Steps 1-3 to determine what is most appropriate clinically. If the patient is suffering from severe pain, using the calculated dose may be appropriate. If the patient is requesting a switch but is otherwise pain controlled, consider a general dose reduction of 25-50% in the new opioid.
Monitor the patient for efficacy and side effects.
While online calculators can be helpful, opioid conversions should be done thoughtfully with a full patient assessment to determine the correct conversion for the individual patient.
McPherson, M. L. M. Demystifying opioid conversion calculations: a guide for effective dosing. American Society of Health-System Pharmacists. Bethesda, MD. 2018.
McPherson MLM. Why equianalgesic tables are only part of the answer to equianalgesia. Ann Palliat Med. 2020; 9(2):537-541.