TAPENTADOL DOSE CONVERSION CHART

TAPENTADOL DOSE CONVERSION CHART

Doses in this conversion chart are approximate equivalent doses only. Caution is always necessary. It should be noted that these equivalent doses relate to analgesic equivalence and not opioid equivalence due to the dual mechanism of action of tapentadol (mu-opioid receptor agonist and noradrenaline reuptake inhibitor). When converting from one strong opioid to another it is important to: take account of the clinical condition of the patient; consider a dose reduction; review after 24 hours and titrate accordingly.

Route of administration

Oral

Drug

Morphine total daily dose

Tapentadol(1) total daily dose

Oxycodone total daily dose

Equivalent Doses

40mg

100mg

20mg

80mg

200mg

40mg

120mg

300mg

60mg

160mg

400mg

80mg

200mg

500mg

100mg

(1) Tapentadol m/r is restricted to patients unable to tolerate morphine m/r under the direction of the Pain Clinic. Total daily doses of tapentadol greater than 500mg have not been studied and are therefore not recommended.

Opioid Formulations and Strengths

Preparations Liquid

Morphine (oral) 10mg/5mL oral solution

Tapentadol (oral)

Oxycodone (oral) 5mg/5mL oral solution

Immediate Release Modified Release

100mg/5mL concentrated oral solution

10mg, 20mg, 50mg tablets

12-hourly tablets: 5mg, 10mg, 15mg, 30mg, 60mg, 100mg, 200mg

Not recommended - 50mg and 75mg tablets are

available but not approved by SMC.*

12-hourly tablets: 50mg, 100mg, 150mg, 200mg, 250mg

10mg/1mL concentrated oral solution

5mg, 10mg, 20mg capsules

12-hourly tablets: 5mg, 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg, 120mg

12-hourly suspension (sachet of granules to mix with water): 20mg, 30mg, 60mg,

100mg, 200mg

*Tapentadol immediate release can only be used under specialist direction where an Individual Patient Treatment Request (IPTR) has been approved.

Caution: tapentadol immediate-release tablets do not allow an appropriate breakthrough dose at total daily doses of tapentadol below 300mg.

Reference: Personal communication. Grunenthal Ltd. 18/10/11.

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