In cases like these conversions you would be safer just first understanding the equivalent conversion of Oxycodone to Fentanyl due to the fact that a 20mg Oxycontin only contains a total of 20 mg which is meant to slowly be released at 1.67 mg/he over 12 hours and the 25 mic fent patch contains 1.8 mg of fentanyl to be released at 25mch/hr. Over 72 hours.
There’s at least one or more apps for opioid conversion/ calculation currently available. There was a really good one called “Opioid tool,” but the author hasn’t updated it in several years so it no longer runs, unfortunately.
Keep in mind that MME-Morphine Milligram Equivalents, is NOT an empirically based conversion tool. The DEA is largely to blame for this disingenuous agenda based “calculation tool”. The Mayo Clinics data, if its still supporting the use of MME, is extremely outdated and should be revised & overhauled years ago. Pain Medicine Doctors using MME do it out of fear of losing their license to practice & nothing else. That must change.
I wanted to add that the biggest misconception about narcotic "pain killers" is just that. "Pain Killers" Opioids and the 3 opiates that exist DO NOT kill pain or block pain or do anything to the pain, what exogenous opioid agonists do is bind to the opioid receptors in the CNS mostly in the brain stem causing intrinsic activity in the receptor releasing higher levels of pleasure causing monoamines. Long story short is that you get high and this changes your perception of pain in a nutshell.
Incomplete cross-tolerance relates to tolerance to a currently administered opiate that does not extend completely to other opioids. This will tend to lower the required dose of the second opioid. This incomplete cross-tolerance exists between all of the opioids and the estimated difference between any two opiates could vary widely. Basically there are inherent dangers of using an equianalgesic table and emphasizes the importance of viewing the tabulated data as approximations.
I don't think your conversations are quite accurate even though it is consistent with many other charts. The POTENCY not EFFICACY of po MSO4 is extremely low due it's vulnerability to first-pass metabolism causing it to have a very low bioavailability. I don't recall if you had Morphine to Oxycodone equivalency on there but to say that po Morphine is equivalent to po Hydrocodone at a 1:1 ratio is nowhere near accurate. Hydrocodone is way more potent than po Morphine. Try to sell a Morphine IR pill in the street and you'll see no addict is interested in Morphine po regardless of high doses. I know both sides of the same story. The formal didactic version of pharmacology and the personal use of opioids and what is valuable/useless to an opioid addict who is in fact only looking for high potency narcotics but with increase in "the euphoria" comes the increase in pain relief.
doc, whats the morphine eq from 25 mcg fent patches to, say, 10 mg oxycontin? the patch is presb 1 every 48 hours.
20mg OxyContin/24hrs = 25 mcg/hour fentanyl patch
60mg of morphine/24hrs = 20mg OxyContin/24hrs
In cases like these conversions you would be safer just first understanding the equivalent conversion of Oxycodone to Fentanyl due to the fact that a 20mg Oxycontin only contains a total of 20 mg which is meant to slowly be released at 1.67 mg/he over 12 hours and the 25 mic fent patch contains 1.8 mg of fentanyl to be released at 25mch/hr. Over 72 hours.
There’s at least one or more apps for opioid conversion/ calculation currently available. There was a really good one called “Opioid tool,” but the author hasn’t updated it in several years so it no longer runs, unfortunately.
That stinks…always good to have a conversion calculator…but just in case people don’t…hopefully this table helps :)
@@SalimRezaie Oh, for sure. As always, I appreciate all the time you spend educating and debunking medical myths.
@@greggae2735 TY so much...appreciate you following, carrying on the conversation, and sharing alike
Keep in mind that MME-Morphine Milligram Equivalents, is NOT an empirically based conversion tool. The DEA is largely to blame for this disingenuous agenda based “calculation tool”.
The Mayo Clinics data, if its still supporting the use of MME, is extremely outdated and should be revised & overhauled years ago. Pain Medicine Doctors using MME do it out of fear of losing their license to practice & nothing else. That must change.
They're trying to get my father off opioids and put him on Tylenol 4 with coding. Does this work and what are some alternatives
Unfortunately do not give medical advice online…
I wanted to add that the biggest misconception about narcotic "pain killers" is just that. "Pain Killers" Opioids and the 3 opiates that exist DO NOT kill pain or block pain or do anything to the pain, what exogenous opioid agonists do is bind to the opioid receptors in the CNS mostly in the brain stem causing intrinsic activity in the receptor releasing higher levels of pleasure causing monoamines. Long story short is that you get high and this changes your perception of pain in a nutshell.
At the end of the day...Opioids simply mask the symptom of pain
I cant see that chart..the letters are too small
Here is a link to a clickable chart that is much larger: rebelem.com/rebel-review/rebel-review-47-narcotic-conversion-chart/narcotic-conversion-chart/
Can someone direct me to the explanation of incomplete cross tolerance?
Incomplete cross-tolerance relates to tolerance to a currently administered opiate that does not extend completely to other opioids. This will tend to lower the required dose of the second opioid. This incomplete cross-tolerance exists between all of the opioids and the estimated difference between any two opiates could vary widely. Basically there are inherent dangers of using an equianalgesic table and emphasizes the importance of viewing the tabulated data as approximations.
@@SalimRezaiefull agonist versus partial agonist or even agonist/antagonist combined medications….
No Suboxone on here?
Nope
If you convert morphine Iv to oral dose
It is generally 1:3...10mg IV morphine = 30mg of PO (Oral) morphine
Yea right. Try, more like 10mg IV Morphine = 1000 mg po Morphine
I don't think your conversations are quite accurate even though it is consistent with many other charts. The POTENCY not EFFICACY of po MSO4 is extremely low due it's vulnerability to first-pass metabolism causing it to have a very low bioavailability. I don't recall if you had Morphine to Oxycodone equivalency on there but to say that po Morphine is equivalent to po Hydrocodone at a 1:1 ratio is nowhere near accurate. Hydrocodone is way more potent than po Morphine. Try to sell a Morphine IR pill in the street and you'll see no addict is interested in Morphine po regardless of high doses. I know both sides of the same story. The formal didactic version of pharmacology and the personal use of opioids and what is valuable/useless to an opioid addict who is in fact only looking for high potency narcotics but with increase in "the euphoria" comes the increase in pain relief.
Agree should be potency NOT efficacy...appreciate your input/insight