Hydromorphone to fentanyl patch conversion
[PDF File]A GUIDE TO EQUIVALENT DOSES FOR OPIOID DRUGS
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Only in exceptional circumstances should the buprenorphine or fentanyl patch be removed and the equivalent opioid dose given in a syringe driver, and only after discussion with the Palliative Care Team. HYDROmorphone – HYDROmorphone is 5–7.5 more potent than morphine. In NSW Health facilities, it should only be prescribed under the ...
[PDF File]Version 1.0 04/29/2020 © Copyright 2020 The General ...
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Hydromorphone 4 mg q6h x24-48 hours Transition to intermittent dosing If tapering multiple agents, consider staggering taper on opposite days Initial Total Daily Oral Dose per Opioid Infusion Requirement Infusion Dose Hydromorphone Oxycodone 0.5 -1.5 mg/hr 30 90 mg 80 240 mg Fentanyl 50-150 mcg/hr 20-60 mg 50-150 mg
[PDF File]Principles and Practice of opioid rotation/switching
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Fentanyl 25mcg/hr patch equivalent to 90mg oral morphine/d (variable 80-100mg) Oxycodone/naloxone 20/10mg 1 tablet q8hrs =60mg oxycodone/day equivalent to 90mg oral morphine/d BUT every patient is different so this is not an exact science and extreme caution has to be exercised!!! Example : Fentanyl patch adherence
Opioid Dose Equivalence Calculation Table
Hydromorphone mg/day 15 Dilaudid FI, Dilaudid-HP FI Codeine mg/day 0.25 Codeine phosphate injection USP Pethidine mg/day 0.4 Pethidine injection BP Fentanyl mcg/day 0.2 DBL fentanyl injection, Sublimaze Sufentanil mcg/day 2 Faculty of Pain Medicine, ANZCA – June 2021
[PDF File]Opioid Switching Tool
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Fentanyl Patch: Use LEVY’s RULE: Patch strength (mcg / hr) = half total daily dose oral morphine (round down to nearest patch strength) MEq = 60 60 / 2 = 30 25mcg / hr fentanyl 6. Define new regime: regular unit doses / frequency & prn opioid medication E.g. 12 hourly dosing = daily dose / 2.
[PDF File]Opioid Conversion Ratios Guide to Palliative Care Practice ...
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Subcutaneous Transdermal Conversion Ratio Example Reference Fentanyl Fentanyl 1:1 Fentanyl 600micrograms / 24 hours = Fentanyl patch 25micrograms/hour 10,14 TRANSMUCOSAL FENTANYL Fentanyl transmucosal products (e.g. lozenges, sublingual and orally-disintegrating tablets) are available for breakthrough cancer pain not adequately managed by other ...
[PDF File]SPECIALIST PALLIATIVE CARE OPIOID DRUG CONVERSION …
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OPIOID DRUG CONVERSION CHART NOTE: When using this chart, calculate the total daily dose of morphine. Once conversion is calculated, ensure opioid dose is prescribed in divided doses as appropriate. SUBCUTANEOUS MORPHINE mg/day SUBCUTANEOUS OXYCODONE mg/day ÷4 TRANSDERMAL FENTANYL PATCH 3 (microgram/hour ORAL OXYCODONE mg/day SUBCUTANEOUS
Pain management in palliative care
Hydromorphone (PO) 6 mg 5:1 Hydromorphone (SC, IM, IV) 3 mg 10:1 Methadone (PO) 5 mg 6:1 (conversion ratio increases with higher doses of morphine, seek specialist advice) Tramadol (PO, SC, IM, IV) 300 mg 1:10 Codeine (PO) 360 mg 1:12 Fentanyl patch (topical) More complex – see conversion table in product disclosure (available on E-MIMS)
[PDF File]Fentanyl Transdermal Patch Guidelines for Use
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What strength fentanyl TD should be prescribed? Total daily morphine = 200 mg PO in 24 hours divided by 3 = 67 mg IV Conversion factor: Morphine 15 mg PO or 5 mg IV = Fentanyl 0.05 mg ๐ = . ๐= . ๐ ๐ฟ = . ๐๐ ÷ = 27.8 mcg/hr Recommend Fentanyl TD 25 mcg/hr patch
[PDF File]Commonly Used Long-Acting Opioids Chart
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Hydromorphone extendedโrelease 8, 12, 16 mg 8 mg once daily Exalgo® ER Fentanyl transdermal 25, 50, 75, 100 mcg/hr patch 25 mcg applied every 3 days Duragesic® Buprenorphine transdermal 5, 10, 20 mcg/hr patch 5 mcg applied every 7 days Butrans® Title: Commonly Used Long-Acting Opioids Chart ...
[PDF File]GUIDELINES FOR OPIOIDS Equivalency Table of Opioids
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Therefore, the starting dose would by Hydromorphone 4 mg s.c. Q4h The prn dose would be Hydromorphone (4 mg X 6) /10 = 2 mg s.c. Q2h EXAMPLE C: CONVERSION OF MORPHINE TO FENTANYL TRANSDERMAL* entanyl is a continuous systematic delivery system dosed in mocrograms per hour. Conversion to equianalgesic doses is les
[PDF File]Common Opioid Oral Morphine Milligram Equivalent (MME ...
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Conversion Factors OPIOID (UNITS) CONVERSION FACTOR Codeine (mg) 0.15 Fentanyl patch (mcg) 7.2 Hydrocodone (mg) 1 Hydromorphone (mg) 4 Meperidine (mg) 0.1 Morphine (mg) 1 Oxycodone (mg) 1.5 Tramadol (mg) 0.1 To calculate daily MME MME/day = Dose size x Doses/Day x MME Factor Example: Tramadol 50 mg BID 50 mg/dose x 2 Doses/day x 0.1 = 10 mg/day
[PDF File]Duragesic Label Page 1 Full Prescribing Information FOR ...
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fentanyl. Schedule II opioid substances which include fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone have the highest potential for abuse and associated risk of fatal overdose due to respiratory depression. Fentanyl can be abused and is subject to criminal diversion. The high content of fentanyl in the patches
[PDF File]OPIOID CONVERSION GUIDE
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Conversion factor (oral dose ÷ by factor = subcut dose) morphine 30 mg 10 mg ÷ 3 hydromorphone 6 mg 2 mg ÷ 3 Transdermal preparation conversions Opioid Equianalgesic oral Patch strength morphine dose buprenorphine 5 microgram/hr 12 mg/24 hrs fentanyl 12 microgram/hr 30-45 mg/24 hrs Sublingual preparation conversions
Sudden Discontinuation of Chronic High Dose Intrathecal ...
150 mcg fentanyl patch was started and immediately postop hydromorphone patient-controlled analgesia (PCA) was started using a continuous infusion of 5 mg/h with a bolus dose of 1 mg every 6 minutes with no lockout. The patient was monitored in the intensive care unit (ICU) for signs and symptoms of withdrawal. During the 24 hour
[PDF File]APPROXIMATE EQUIVALENT OPIOID DOSES
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24mg Hydromorphone is the equivalent daily dose. The patient would therefore be prescribed 12 mg Hydromorphone modified release twice daily with 3.9mg immediate release hydromorphone for breakthrough (1 sixth (1/6) of the total daily dose). Route of administration Oral Transdermal Drug Morphine total daily dose Hydromorphone total daily dose
[PDF File]Opioid Conversion Calculator
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Hydromorphone Conversions are complex. 1.3mg oral hydromorphone is equivalent to 10mg oral morphine. Please seek advice. Parenteral Diamorphine ×2 ÷2 ÷2 ×3 ÷3 Parenteral Morphine ÷2 ×2 ÷30 ×30 ×2 × 10 ÷ Opioid Conversion Calculator Depending on age, comorbidities and prior side effects, consider reducing the dose of the
Opioid Conversion Tables - ASHP
Opioid Conversion Tables . Ernest Dole , Pharm.D., BCPS , PhC, FASHP . Clinical Pharmacist , University of New Mexico Hospitals . Chronic Pain C onsultation & Treatment Center . Table 1: Pharmacokinetic Data for Oral Opioids . Starting Dose Onset Peak Duration Half life Codeine 30 - 60 mg q 4 hr 30 min 1.5 hr 6 hours 2-4 hr Morphine SA
[PDF File]s Opiate Equianalgesic Dosing Chart Committee
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s Opiate Equianalgesic Dosing Chart Committee 1nn s of age. 2nue to dimi i conti 3ncombtions must al g ht. 4nioid-t te-naïve patie ue to cumulative effects . 09. urs) 4-11 12 8-22 25 23-37 50 38-52 75 53-67 100 68-82 125 83-97 150
[PDF File]Part 2: Pain and Symptom Management Pain Management
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Renal failure fentanyl transdermal or methadonea morphineb, codeine, meperidinec Compliance and convenience time release formulations (e.g., morphine, hydromorphone, oxycodone) Neuropathic pain oxycodone or methadoned (anecdotal evidence) Opioid naïve low dose morphine, hydromorphone or oxycodone fentanyl transdermal patch (risk of
[PDF File]Opioid Conversion Chart
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Fentanyl patch 72hrly ... (The manufacturers conversion rates differ from the recommendations of palliativedrugs.com. Individual variance in response to opioids is always to be ... • Hydromorphone only used infrequently: approximately 7.5 times as potent as Morphine orally.
[PDF File]Opioid Conversion Guidelines
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Oral Morphine to Oral Hydromorphone 5 : 1 Oral Morphine 5mg = Oral Hydromorphone 1mg ** Conversion to methadone from other opioids is complex, ... (BTD) for a given Fentanyl Patch For a given Fentanyl Patch of x mcg/hr: BTD = x/5 micrograms of Sufentanil 2 hourly e.g. for Durogesic 25: BTD = 25/5 i.e. 5 microgram Sufentanil 2 hourly ...
[PDF File]Indications for Best Practice Addiction Excessive Sedation w/ Opioids
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Hydromorphone 2mg (Dilaudid) PO Q 2 - 4h prn ... Fentanyl Patch 100mcg Q72h ... Fentanyl patch 50mcg/hr approx. equivalent to oral morphine 100mg/day.
[PDF File]Equianalgesic Conversions
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Hydromorphone. Semi-synthetic ... Fentanyl. Synthetic. ---. Meperidine. Sufentanil. Synthetic ... CONVERTING MORPHINE TO TRANSDERMAL FENTANYL.
[PDF File]Methadone: Are You Prepared To Use It? - American Society for ...
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Sep 13, 2012 ... Fentanyl Patch (Duragesic) 100mcg q72h ... Hydromorphone, etc. ... patch. 48-72. Conversion is Not Linear for. Morphine to Methadone.
[PDF File]MCSTAP Tip Sheet For Initiating Long Acting Opioids
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Fentanyl transdermal patch (Duragesic) ... Step One: Convert all current opioid agents to Morphine Equivalent Daily Dose (MEDD) per day.
[PDF File]GUIDELINES FOR THE USE OF TRANSDERMAL OPIOIDS IN ...
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Transdermal fentanyl is less constipating than morphine, oxycodone or hydromorphone. Consider halving the dose of laxative when converting from.
[PDF File]Page 1 of 8 - Kansas Department of Health
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Jan 10, 2018 ... Fentanyl transdermal (Duragesic). Hydrocodone extended-release (Zohydro ER, Hysingla ER). Hydromorphone extended-release (Exalgo). Methadone.
[PDF File]Duragesic_USPI_20210305_PA...
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least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour,. 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral.
Prior Authorization Approval Criteria - Exalgo (hydromorphone)
Sep 8, 2010 ... Exalgo (hydromorphone) ... a Ratio for conversion of oral opioid dose to approximate ... Conversion from Transdermal Fentanyl to EXALGO.
[PDF File]Drug Use Criteria: Inhalation/Oral/Transdermal Fentanyl
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Dec 5, 2019 ... daily, 8 mg of oral hydromorphone daily or an equianalgesic dose of another ... Opioid Dosage Conversion to Fentanyl Transdermal Patch.
[PDF File]A Review of Unique Opioids and Their Conversions
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Practical Pain Management. Sept. 2012. 46-51. Donner B, et al. Direct conversion from oral morphine to transdermal fentanyl: a multicenter study in patients ...
[PDF File]Fast Facts Core Curriculum Opioid Products - Palliative Care ...
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Products 15 - 60 ... converting from another opioid to transdermal fentanyl. ... Cautions Unlike morphine, hydromorphone, or oxycodone, methadone has an extended.
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