Drug

Oral/Rectal Route

Parenteral Route

Conversion Ratio to
Oral Morphine

Equianalgesic Dose of Oral Morphine

Morphine sulfate

30mg Oral morphine

10mg of parenteral morphine

Parenteral morphine is 3 times as potent as oral morphine

30mg ORAL morphine

Oxycodone

20mg of oral oxycodone

NA

Oral Oxycodone is roughly 1.5 times more potent than oral morphine

Hydrocodone

20mg of oral hydrocodone

NA

Oral hydrocodone is roughly 1.5 times more potent than oral morphine

Hydromorphone

7mg of oral hydromorphone

1.5mg of parenteral hydromorphone

Oral hydromorphone is about 4-7 times as potent as oral morphine
Parenteral hydromorphone is 20 times as potent as oral morphine

Fentanyl

NA

15 micrograms/hr

Transdermal fentanyl is approximately 80 times as potent as morphine
(This is based on studies converting from Morphine to fentanyl. Currently, there are no empirical studies converting fentanyl to morphine).

Meperidine
Meperidine is not a recommended drug in a palliative care setting.If a patient with chronic pain is on meperidine, convert to an equianalgesic dose of one of the other opioids listed in this table.

300mg of oral meperidine

75mg of parenteral meperidine

Oral Morphine is about 10 times more potent than oral meperidine and about twice more potent as parenteral meperidine (mg for mg)