Morphine PO (mg/d)

Hydromorphone PO (mg/d)

Oxycodone PO (mg/d)

Fentanyl patch (microg/h)

45-59

6-11

30-44

12d

60-134

12-26

45-89

25d

135-179

27-35

90-119

37

180-224

36-44

120-149

50

225-269

45-53

150-179

62

270-314

54-62

180-209

75

315-359

63-71

210-239

87

360-404

72-80

240-269

100

405-449

81-89

270-299

112

450-494

90-98

300-329

125

495-539

99-107

330-359

137

540-584

108-116

360-389

150

585-629

117-125

390-419

162

630-674

126-134

420-449

175

675-719

135-143

450-479

187

720-764

144-152

480-509

200

765-809

153-161

510-539

212

810-854

162-170

540-569

225

855-899

171-179

570-599

237

900-944

180-188

600-629

250

945-989

189-197

630-659

262

990-1034

198-206

660-689

275

1035-1079

207-215

690-719

287

1080-1124

216-224

720-749

300

Patients using an oral opiate in the dose range listed in the table can be carefully converted to transdermal fentanyl in the dose in the corresponding far right column.

a Initiation of fentanyl in patients who are opioid-naive is contraindicated at any dose.

b The conversion table is unidirectional only and can only be used to convert adult patients from their current oral or parenteral opioid analgesics to the approximate fentanyl transdermal patch for use in chronic pain.

c Do not convert patients previously on codeine or tramadol to fentanyl transdermal patch due to significant interpatient variability in metabolism, safety, and effectiveness of these drugs.

d Health Canada recommends that 12 microg/h patches be used for dose titration or adjustments, not as the initiating dose.