Menu
GP Pain Help LogoGP Pain HelpContent
CPCREACRRM
🌜
🌞
GP Pain Help LogoGP Pain Help
  • Content
  • CPCRE
  • ACRRM
  • Content
    • Introduction
    • Responses to Patient FAQs
    • Treatment tree
      • Get Started
      • Mild to Moderate Pain
      • Moderate to Severe Pain
      • Breakthrough Pain
    • Precautions When Using Opioids
    • Difficult Pain Control
    • Equianalgesic Dosing
    • Incident Pain
    • Mode of Action
    • Morphine Myths and Facts
    • Route of Delivery
  • Opioids
    • Choosing an Opioid
    • Opioid Comparative Information Table
    • Opioid Formulation Table
    • Opioids in Special Populations
    • Opioids to Avoid
  • Individual Opioids
    • Buprenorphine
    • Codeine
    • Fentanyl
    • Hydromorphone
    • Methadone
    • Morphine
    • Oxycodone
    • Tramadol
    • Tapentadol

Equianalgesic Dosing

Changing opioid#

If the adverse effects of an opioid become intolerable, switching to an alternative opioid may help. When changing drugs, consider equianalgesic doses. Start at less than the dose indicated in the opioid comparative information table as there may be incomplete cross-tolerance between opioids. Monitor closely and titrate dose depending on assessment of pain control. Use breakthrough doses of opioid, if required, to establish adequate analgesia.

Changing administration route, same opioid#

Changing the route of administration, e.g to subcutaneous infusion, may improve analgesia.

Previous
« Difficult Pain Control
Next
Incident Pain »
  • Changing opioid
  • Changing administration route, same opioid
Copyright ©2021
Built by ACRRM on behalf of CPCRE

    Welcome

    Welcome to the GP Pain Help App, to help GPs manage cancer pain in their patients.

    General principles

    Opioids are the only pharmacological class of drug with the ability to control severe pain.

    Use oral route first line where possible.

    Dose regularly with controlled-release (CR) preparations, with as required (prn) immediate-release (IR) doses (1/6 daily dose) to assess analgesic requirements.

    Titrate dose against effect and toxicity – consider switching to another class of opioid if toxicity becomes dose-limiting.

    Disclaimer

    The information within this app is presented by the Centre for Palliative Care Research and Education (CPCRE) for the purpose of disseminating health information free of charge and for the benefit of the healthcare professional.

    While CPCRE has exercised due care in ensuring the accuracy of the material herein, the information provided should be treated as a guide only to appropriate practice, to be followed subject to the clinician’s judgment and the patient’s preference in each individual case.

    CPCRE does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information contained herein.

    Acknowledgement

    CPCRE acknowledges the work of Professor Janet Hardy, Associate Professor Phillip Good and the Australian College of Rural and Remote Medicine (ACRRM) in development of this pain aid for GPs.