Approximate oral equianalgesic doses for commonly used opioids

Drug	Approximate equivalent doses (oral immediate-release preparations)	Approximate equianalgesic dose ratio (morphine:alternate opioid)
Codeine*	200 mg	1:7
Fentanyl	No oral equivalent
Hydrocodone	30 mg	1:1
Hydromorphone	7.5 mg	4:1
Morphine	30 mg	1:1 (reference standard)
Oxycodone	20 mg	1.5:1
Oxymorphone	10 mg	3:1
Tapentadol	75 mg	0.4:1
Tramadol	300 mg	0.1:1

Equianalgesic conversions serve only as a general guide to estimate opioid dose equivalents. For a review of multiple factors that must be considered for safely individualizing conversion of opioid analgesia, refer to UpToDate topic on cancer pain management with opioids: optimizing analgesia.

* Generally not recommended due to high variability in response.

Data from: Calculating total daily dose of opioids for safer dosage. US Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf (Accessed on July 21, 2021).

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