From the Guidelines
The morphine equivalent dose of 20 mg of oxycodone is 30 mg of oral morphine, based on the most recent and highest quality study available 1. This means that 20 mg of oxycodone provides approximately the same pain relief as 30 mg of oral morphine.
Key Points to Consider
- The conversion is based on an oxycodone-to-morphine potency ratio of 1.5:1, which is commonly used in clinical practice for equianalgesic dosing calculations 1.
- When converting between opioids, it's essential to understand these equivalencies to maintain effective pain control while minimizing risks.
- Individual patient responses may vary based on factors such as prior opioid exposure, age, and medical conditions.
- When switching between opioids, it's generally recommended to reduce the calculated equianalgesic dose by 25-50% initially to account for incomplete cross-tolerance and then titrate as needed based on pain control and side effects.
Important Considerations
- Equianalgesic dose conversions are only estimates and cannot account for individual variability in genetics and pharmacokinetics 1.
- Particular caution should be used with methadone dose conversions because methadone has a long and variable half-life, and peak respiratory depressant effect occurs later and lasts longer than peak analgesic effect 1.
- The conversion factors should not be applied to dosage decisions related to the management of opioid use disorder 1.
From the Research
Opioid Equivalent Doses
- The morphine equivalent dose of 20 mg of oxycodone is not directly stated in the provided studies 2, 3, 4, 5, 6.
- However, study 4 discusses the use of strong-acting opioids, including oxycodone, in elderly patients, but does not provide specific equivalent doses.
- Study 3 mentions the metabolism and disposition of oxycodone, but does not provide information on equivalent doses.
- Since there is no direct information available, the morphine equivalent dose of 20 mg of oxycodone cannot be determined from the provided studies 2, 3, 4, 5, 6.
General Information on Opioid Dosage
- Study 4 provides evidence-based recommendations for prescribing strong opioids to elderly patients, but does not include specific dosage information.
- Study 2 discusses the use of opioids in cancer pain management, but does not provide information on equivalent doses.
- Study 5 investigates opioid-induced hypoglycaemia, but does not discuss dosage equivalences.
- Study 6 examines the toxicity of six commonly used opioids, but does not provide information on equivalent doses.