Table 5. Dosing Data for Opioid Analgesics

Opioid Agonist
Drug                Approximate          Approximate       Recommended starting dose         Recommended starting dose
equianalgesic       equianalgesic       (adults more than 50kg           (children and adults less
                    oral dose          parenteral dose          body weight)                 than 50kg body weight)[1]
                                                           oral             parenteral       oral             parenteral
___________________________________________________________________________________________________________________________
Morphine[2]       | 30 mg q 3-4 hr   | 10 mg q 3-4 hr | 30 mg q 3-4 hr |  10 mg q 3-4 hr | 0.3 mg/kg      | 0.1 mg/kg
                  | (around-the-clock|                |                |                 | q 3-4 hr       | q 3-4 hr
                  | dosing)          |                |                |                 |                |
                  |__________________|________________|________________|_________________|________________|________________
                  | 60 mg q 3-4 hr   |                |                |                 |                |
                  | (single dose or  |                |                |                 |                |
                  | intermittent     |                |                |                 |                |
                  | dosing           |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
Codeine[3]        | 130 mg q 3-4 hr  | 75 mg q 3-4 hr | 60 mg q 3-4 hr |  60 mg q 2 hr   | 1 mg/kg        | Not recommended
                  |                  |                |                |(intramulcular/  | 3-4 hr [4]     |
                  |                  |                |                |subcutaneous)    |                |
__________________|__________________|________________|________________|_________________|________________|________________
Hydromophone[2]   | 7.5 mg q 3-4 hr  | 1.5 mg q 3-4 hr| 6 mg q 3-4 hr  | 1.5 mg q 3-4 hr | 0.06 mg/kg     | 0.015 mg/kg
(Dilaudid)        |                  |                |                |                 | q 3-4 hr       | q 3-4 hr
__________________|__________________|________________|________________|_________________|________________|________________
Hydrocodone (in   | 30 mg q 3-4 hr   | Not available  | 10 mg q 3-4 hr | Not available   | 0.06 mg/kg     | Not available
Lorcet, Lortab,   |                  |                |                |                 | q 3-4 hr [4]   |
Vicodin, others)  |                  |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
Levorphanol       |  4 mg q 6-8 hr   | 2 mg q 6-8 hr  | 4 mg q 6-8 hr  | 2 mg q 6-8 hr   | 0.04 mg/kg     | 0.02 mg/kg
(Levo-Dromoran)   |                  |                |                |                 | q 6-8 hr       | q 6-8 hr
__________________|__________________|________________|________________|_________________|________________|________________
Meperidine        | 300 mg q 2-3 hr  | 100 mg q 3 hr  | Not recommended| 100 mg q 3 hr   | Not recommended| 0.75 mg/kg
(Demerol)         |                  |                |                |                 |                | q 2-3 hr
__________________|__________________|________________|________________|_________________|________________|________________
Methadone         | 20 mg q 6-8 hr   | 10 mg q 6-8 hr | 20 mg q 6-8 hr | 10 mg q 6-8 hr  | 0.2 mg/kq      | 0.1mk/kg
(Dolophine,others)|                  |                |                |                 | q 3-4 hr [4]   | q 6-8 hr
__________________|__________________|________________|________________|_________________|________________|________________
Oxycodone         | 30 mg q 3-4 hr   | Not available  | 10 mg q 3-4 hr | Not available   | 0.2 mg/kg      | Not available
(Roxicodone, also |                  |                |                |                 | q 3-4 hr [4]   |
in Percocet,      |                  |                |                |                 |                |
Percodan, Tylox,  |                  |                |                |                 |                |
others)           |                  |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
Oxymorphone2      | Not available    | 1 mg q 3-4 hr  | Not available  | 1 mg q 2-3 hr   | Not recommended| Not recommended
(Numorphan)       |                  |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
Opioid Agonist-Antagonist and Partial Agonist
___________________________________________________________________________________________________________________________
Buprenorphine     | Not available    | 0.3-0.4 mg     | Not available  | 0.4 mg q 6-8 hr | Not available  | 0.0004 mg/kg
(Buprenex)        |                  | q 6-8 hr       |                |                 |                | q 6-8 hr
__________________|__________________|________________|________________|_________________|________________|________________
Butorphanol       | Not available    | 2 mg q 3-4 hr  | Not available  | 2 mg q 3-4 hr   | Not available  | Not recommended
(Stadol)          |                  |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
Nalbuphine        | Not available    | 10 mg q 3-4 hr | Not available  | 10 mg q 3-4 hr  | Not available  | 0.1 mg/kg
(Nubain)          |                  |                |                |                 |                | q 3-4 hr
__________________|__________________|________________|________________|_________________|________________|________________
Pentazocine       | 150 mg q 3-4 hr  | 60 mg q 3-4 hr | 50 mg q 4-6 hr | Not recommended | Not recommended| Not recommended
(Talwin, others)  |                  |                |                |                 |                |
__________________|__________________|________________|________________|_________________|________________|________________
________________ Note: Published tables vary in the suggested doses that are equianalgesic to morphine. Clinical response is the criterion that must be applied for each patient; titration to clinical response is necessary. Because there is not complete cross tolerance among these drugs, it is usually necessary to use a lower than equianalgesic dose when changing drugs and to retitrate to response. ________________ Caution: recommended doses do not apply to patients with renal or hepatic insufficiency or other conditions affecting drug metabolism and kinetics. ________________ [1] Caution: Doses listed for patients with body weight less than 50 kg cannot be used as initial starting doses in babies less than 6 months of age. consult the Clinical Practice Guideline for Acute Pain Management: Operative or Medical Procedures and Trauma section on management of pain in neonates for recommendations. ________________ [2] For morphine, hydromorphone, and oxymorphone, rectal administration is an alternate route for patients unable to take oral medications, but equianalgesic doses may differ from oral and parenteral doses because of pharacokinetic differences. ________________ [3] Caution: Codeine doses above 65 mg often are not appropriate due to diminishing incremental analgesia with increasing doses but continually increasing constipation and other side effects. ________________ [4] Caution: Doses of aspirin and acetaminophen in combination opioid/NSAID preparations must also be adjusted to the patient's body weight.