What are the equivalent doses of oral morphine to other oral opioids when used as analgesics in adult palliative care?

Morphine is generally the strong opioid of choice for treating moderate to severe cancer pain and a common question is how to convert a dose of another opioid to morphine or vice versa. Other opioids may be preferred, for example, if a patient obtains insufficient pain relief with morphine (or other strong opioid) and/or is suffering severe adverse effects.

This Q&A gives advice on converting between oral morphine and other oral opioids when they are used as analgesics in adult palliative care. In addition it gives details on the issues that need to be considered hinewhen switching a patient from morphine to an alternative opioid or vice versa.

Anaesthesia and painBuprenorphineCodeineDihydrocodeineHydromorphoneMorphineOxycodonePalliative and End of Life CareQ&ATapentadolTramadol

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