From the Guidelines
The equianalgesic dose of morphine IV for hydromorphone 1mg IV is approximately 6.67 mg, based on the ratio of equianalgesic doses provided in the clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit 1. This conversion is crucial when switching between opioid medications to maintain adequate pain control while avoiding under or overdosing.
- Hydromorphone (Dilaudid) is more potent than morphine on a milligram-to-milligram basis, which explains the ratio.
- The table provided in the guidelines lists the equianalgesic dose of morphine as 10mg and hydromorphone as 1.5mg, resulting in a ratio of approximately 6.67:1. When making this conversion in clinical practice, it's essential to consider individual patient factors such as:
- Age
- Renal function
- Prior opioid exposure
- Pain severity Additionally, due to incomplete cross-tolerance between opioids, when switching from one opioid to another, a dose reduction of 25-50% from the calculated equianalgesic dose is often recommended to reduce the risk of adverse effects while maintaining pain control, as suggested by the guidelines 1. Close monitoring for efficacy and side effects is essential after any opioid conversion.
From the Research
Equianalgesic Dose of Morphine IV for Hydromorphone 1mg IV
- The equianalgesic dose of morphine IV for hydromorphone 1mg IV is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 5 discusses equianalgesic dosing of opioids, including hydromorphone, but does not provide a specific conversion ratio for hydromorphone 1mg IV to morphine IV.
- Study 4 mentions that the issue of equi-analgesic ratios between morphine and hydromorphone was not resolved in the context of both acute and chronic pain.
- Study 3 compares the efficacy and safety of hydromorphone and morphine in older adults with acute, severe pain, but does not provide a direct conversion ratio.
- Study 6 also explores the evidence for the efficacy of hydromorphone in the management of pain, but does not provide a specific equianalgesic dose ratio for hydromorphone to morphine.
- Study 2 provides a lecture and infographic on morphine equianalgesic doses, but does not specifically address the conversion ratio for hydromorphone 1mg IV to morphine IV 2.