Substance	Route
Morphine	PO	mg
Oxycodone (Percocet)	PO	mg
Hydromorphone (Dilaudid)	PO	mg
Meperidine (Demerol)	PO	mg
Hydrocodone (Vicodin/Norco)	PO	mg
Methadone	PO	mg
Fentanyl	Patch	mcg/hr
Morphine	IV	mg
Hydromorphone (Dilaudid)	IV	mg
Meperidine (Demerol)	IV	mg
Fentanyl	IV	mcg

General approach to dosing an oral opioid regimen: Provide 100% of expected MED (morphine equivalents) in long acting form, as well as ~15% PRN option for breakthrough pain with dosing interval comparable to medication half life (q3-4h for oral meds), and retitrate daily. Note that if changing agents, should decrease estimated dosing 25-50% given variable cross-tolerance to different agents. (Dosing values should be rounded to nearest formulation doses)

Methadone (dose BID or TID)
Sliding Scale Conversion Ratios

Morphine (PO mg)	Morphine : Methadone
<30	2:1
<100	4:1
<300	8:1
<500	12:1
<1000	15:1
>1000	20:1

Caution: Methadone is a potent medication with unreliable conversions.
Generally safer to just start at a low dose and slowly titrate up every 3 days

Fentanyl Parenteral (Patch)
Sliding Scale Conversion

Fentanyl (mcg/hr x 24hr)	Morphine (PO mg)
25	50
75	250
100	350

Opioid Equivalence Table Reference