What Principles Should Guide Opioid Dose Conversions?

Opioids can be part of a safe and effective pain management strategy for patients when prescribed according to evidence-based guidelines. Clinicians may wish to change from one opioid or route to another for a variety of reasons, including lack of therapeutic efficacy, intolerable side effects, or patient preference. There are many commercially available prescribed opioids, and clinicians must choose a particular drug, route, and dose. Different drugs and routes have different potencies, and this poses a challenge to clinicians who wish to convert from one opioid to another.