how to switch opioids

September 2004

All the current emphasis on pain management and end-of-life care is raising questions about how to switch opioids.

Opioids are often switched to improve pain control or reduce side effects. Prescribers are asking how to estimate equivalent analgesic doses.

Morphine 30 mg PO is roughly equivalent to hydromorphone 7.5 mg... oxycodone 20 mg...or hydrocodone 30 mg.

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Table of Contents

National Advisory Committee on Immunization is broadening the list of people who should get flu vaccine this year
Diabetes more relaxed about liver testing for Actos and Avandia
Cardiology Does Altace (ramipril) improve survival after a heart attack better than other ACE inhibitors
Cardiology increased use of spironolactone for heart failure is causing more hospitalizations and deaths
Dermatology a new prescription "nail polish" called Penlac
a new antidepressant, Cymbalta
significant new drug for alcohol dependence called Campral in the pipeline
Renal & Urology nifedipine or tamsulosin (Flomax) to help expel SMALL kidney stones
Cholesterol Vytorin, the new combo tablet for hyperlipidemia
Smoking Cessation help patients and physicians choose the right one
Hematology & Oncology Faslodex (fulvestrant), a new drug for metastatic breast cancer
Women's Health increasing levothyroxine doses by one-third as soon as pregnancy is confirmed
Women's Health pros and cons of soy for postmenopausal women
Neurology & Pain how to switch opioids