Opioid drug	Equianalgesic dosage		Initial oral dosage	Comments
	Oral dosage	Parenteral dosage
Morphine	30 mg every 3 to 4 hours	10 mg	30 mg every 4 hours	Available in a long-acting preparation
Codeine	180 mg every 3 to 4 hours	NA	60 mg every 3 to 4 hours	Higher incidence of side effects than morphine
Oxycodone (Roxicodone)	30 mg every 3 to 4 hours	10 mg	10 mg every 3 to 4 hours	Available in a long-acting preparation
Hydromorphone (Dilaudid)	7.5 mg every 3 to 4 hours	1.5 mg	6 mg every 3 to 4 hours	Lower incidence of side effects than morphine
Levorphanol (Levo-Dromoran)	4 mg every 6 to 8 hours	2 mg	4 mg every 6 to 8 hours	Higher incidence of side effects than morphine
Methadone	20 mg every 6 to 8 hours	10 mg	20 mg every 6 to 8 hours	Lower incidence of side effects than morphine
				Conversion to methadone at higher dosages may require only 3 to 5 mg per 30 mg of morphine
Oxymorphone (Numorphan)	NA	1 mg every 3 to 4 hours	NA
Tramadol (Ultram)	100 mg four times daily	80 mg	50 mg every 6 hours	Maximum of 8 tablets per day
Fentanyl (Duragesic)	24-hour dose of any of the above is equivalent to 50 μg per hour of transdermal fentanyl		25 μg per hour patch	Lower incidence of side effects than morphine Best used in patients with stable pain because the patch is applied only every three days
Meperidine (Demerol)*	300 mg every 3 to 4 hours	75 mg	NR	Possible accumulation of toxic metabolites
Butorphanol (Stadol)*	NA	2 mg	NA	Can cause withdrawal symptoms in opioid-dependent patients
Nalbuphine (Nubain)*	NA	10 mg	NA	Can cause withdrawal symptoms in opioid-dependent patients
Pentazocine (Talwin)*	180 mg	60 mg		Can cause withdrawal symptoms in opioid-dependent patients
Buprenorphine (Buprenex)*	NA	0.3 mg	NA	Can cause withdrawal symptoms in opioid-dependent patients