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

a new antidepressant, Cymbalta
Cholesterol a new combo tablet, Vytorin
Diabetes Liver function tests are now required less often for patients taking Actos (pioglitazone) or Avandia (rosiglitazone)
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
Infectious Diseases A new quinolone, Factive, is hitting the market
Infectious Diseases The CDC is broadening the list of people who should get flu vaccine this year
Bristol-Myers Squibb has VOLUNTARILY stopped selling Serzone (nefazodone)
significant new drug for alcohol dependence called Campral
Renal & Urology Sanctura, a new drug for overactive bladder
Renal & Urology nifedipine or tamsulosin (Flomax) to help expel SMALL kidney stones
Supplements Altovis, Red Bull, Umph, and other energy supplements
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