Paediatric Palliative Care Guidelines
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Edition/Revision: 4.0
Validated 22 Oct 2016

Converting opioid doses

Converting to Transdermal Buprenorphine

Buprenorphine patches are approximately equivalent to the following 24-hour doses of oral morphine

Morphine salt

Daily dose

 

Patch

Change

12mg

BuTrans® ‘5’ patch

7-day

24mg

BuTrans® ‘10’ patch

7-day

48mg

BuTrans® ‘20’ patch

7-day

84mg

Transtec® ‘35’ patch

4-day

126mg

Transtec® ‘52.5’ patch

4-day

168mg

Transtec® ‘70’ patch

4-day

Converting from oral morphine solution
  • Continue oral morphine for 12 – 24 hrs after start of buprenorphine patch until therapeutic levels are reached
  • Evaluate analgesic dose after 24 – 72hrs
  • Provide PRN doses of either oral morphine or sublingual buprenorphine for breakthrough pain
  • It may take approx 30 hrs for the plasma concentration to decrease by 50% after patch is removed

Licence: Licensed for use in children over the age of 6 years. Cutting the patches is not recommended by manufacturers. Sublingual tablets no licensed under 6 yrs.

OPIOID POTENCY RATIOS

 

Route

Relative potency to oral morphine

Codeine

Oral

0.1

Dihydrocodeine

Oral

0.1

Buprenorphine

Sublingual

60

Pethidine

Oral

0.125

IM

0.375

Tramadol

Oral

0.1-0.2

Morphine

SC infusion

2

Diamorphine

SC infusion

3

 

Oxycodone

Oral

2

SC infusion

3-4

 

Fentanyl

Patch

150

SC infusion

150

Alfentanil

SC infusion

30

Hydromorphone

Oral

5-10

See Opioid Conversion Guide in adult section

Edition/Revision: 4.0
Created 21 Oct 2016
Validated 22 Oct 2016 by Ian Back
Last modified 15 May 2021
Mon 17 May 2021 01:55:34 GMT +0100 (DST)
Last modified 15 May 2021