http://www.nhhpco.org/opioid.htm
New Hampshire Hospice and Palliative Care Organization
This Opioid Use Guidelines have been prepared by the NHHPCO Palliative Care Clinicians Special Interest Group as part of their 'Best Practices Project'.
Steps to Rotate or Change Opioids
1. Calculate 24 hr dose of current drug.
2. Translate that to equianalgesic 24 hr dose of oral morphine.
3. Calculate 24 hr equianalgesic dose of new drug and reduce dose to 50-75% of calculated dose if pain is well controlled; use 100% otherwise.
4. Divide to attain appropriate interval and dose for new drug.
5. Always have breakthrough dosing available while making changes.
