Dose Equivalence Table for Opioid Analgesics

Equianalgesic tables aid the clinician in making these conversions by providing a rough estimate for starting doses of the new opioid that may produce approximately the same amount of analgesia. Morphine (10 mg IM) is the gold standard to which all other opioids are compared.

Drug	Equivalent dose (mg) (compared to morphine 10 mg IM)		Duration of action (Hours)
	Parenteral	Oral
Strong Opioids Agonists
Morphine	10	60	3-4
Oxycodone	15	30	2-4
Hydromorphone	1.5	7.5	2-4
Anileridine	25	75	2-3
Levorphanol	2	4	4-8
Meperidine	75	300	1-3
Oxymorphone	1.5	5 (rectal)	3-4
Methadone	-	-	-
Heroin	5-8	10-15	3-4
Weak Opioids Agonists
Codeine	120	200	3-4
Propoxyphene	50	100	2-4
Mixed Agonists-Antagonists
Pentazocine	60	180	3-4
Nalbuphine	10	-	3-6
Butorphanol	2	-	3-4

Total daily oral morphine equivalent conversion table.

Drug	Dose × conversion factor
Pethidine (oral)	×0.125
Pethidine (i.v.)	×0.4
Methadone	×1.5
Oxycodone	×1.5
Buprenorphine	×50
Tramadol	x0.20
Codeine	×0.16
Dextropropoxyphene	×0.1
Morphine (i.v.)	×3
Morphine (oral)	×1

References:

1. Nissen LM, Tett SE, Cramond T, Williams B, Smith MT. Opioid analgesic prescribing and use - an audit of analgesic prescribing by general practitioners and The Multidisciplinary Pain Centre at Royal Brisbane Hospital. Br J Clin Pharmacol. 2001 Dec;52(6):693-8. [Medline]
2. Argoff CE, Silvershein DI. A comparison of long- and short-acting opioids for the treatment of chronic noncancer pain: tailoring therapy to meet patient needs. Mayo Clin Proc. 2009 Jul;84(7):602-12. [Medline]