Use our tool to obtain approximate dose equivalences of oral morphine to other oral opioids and help you calculate an estimated equivalent daily dose.

Using our advice

If you have not done so already, refer to the first article in this series before using this tool. 

Switching between morphine and other opioids in palliative care

Switching between oral morphine and other oral opioids requires care and thoughtful application of a stepped process.

About the tool

Use our tool to calculate an estimated equivalent dose of oral morphine to other oral (non-morphine) opioids for pain management in adult cancer or palliative care patients.

Depending on the context of the switch, you may need to consider a dose reduction. Our advice on morphine and opioid switching provides background information.

Potency equivalences within the tool are derived from a variety of information sources, including manufacturers’ data, specialist references, and published medical literature.

We provide equivalence information for oral morphine and a selection of other oral opioids commonly used in cancer and palliative care.

Convert to oral morphine from another opioid

Multiply the total daily dose of oral opioid by its potency equivalence.

Convert to a non-morphine opioid from oral morphine

Divide the total daily dose of oral morphine by the potency equivalence for the oral opioid you are converting to.

Disclaimer

The tool is not suitable for clinical settings other than palliative cancer care pain in adults. It is not suitable for routes of administration other than the oral route.

Calculate equivalence

Select whether you're switching from morphine to a non-morphine opioid; or from a non-morphine opioid to morphine.

Medicines selection

To switch from oral morphine to an oral non-morphine opioid, select the non-morphine oral opioid you're switching to.

To switch from a non-morphine oral opioid to oral morphine, select the non-morphine oral opioid you're switching from.

Conversions

Divide the total daily dose of morphine by 0.1 to obtain an equivalent dose of codeine.

Divide the total daily dose of morphine by 0.1 to obtain an equivalent dose of dihydrocodeine.

Divide the total daily dose of morphine by 5 to 7.5 to obtain an equivalent dose of hydromorphone.

Divide the total daily dose of morphine by 1.5 to 2 to obtain an equivalent dose of oxycodone.

Divide the total daily dose of morphine by 0.3 to 0.4 to obtain an equivalent dose of tapentadol.

Divide the total daily dose of morphine by 0.1 to obtain an equivalent dose of tramadol.

Multiply the total daily dose of codeine by 0.1 to obtain an equivalent dose of morphine.

Multiply the total daily dose of dihydrocodeine by 0.1 to obtain an equivalent dose of morphine.

Multiply the total daily dose of hydromorphone by 5 to 7.5 to obtain an equivalent dose of morphine.

Multiply the total daily dose of oxycodone by 1.5 to 2 to obtain an equivalent dose of morphine.

Multiply the total daily dose of tapentadol by 0.3 to 0.4 to obtain an equivalent dose of morphine.

Multiply the total daily dose of tramadol by 0.1 to obtain an equivalent dose of morphine.

Example scenario

An example oral opioid switch from morphine to oxycodone helps you understand how to apply the tool in clinical practice.

Update history

  1. Minor changes to structure and wording. Morphine equivalences for hydromorphine, tapentadol and tramadol amended to bring into line with other commonly used reference sources.
  2. Full review and update complete.
  3. Published

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