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  • 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

Opioid Comparative Information Table

Agonists#

DrugApprox dose to 10mg IM/SC morphine (30mg oral)Approx duration of actionComments
Tramadol100-120mg IM/IV; 150mg oral3-6 hours; 12-24hrs for controlled releaseModerate pain
Fentanyl100-150mcg SC1-2 hours IMModerate to severe pain; preferred in renal impairment
Hydromorphone1.5 mg SC/IM; 6 mg oral2-4 hours; 24hrs for controlled releaseModerate to severe pain
Methadonecomplex; discuss conversion with a pain or palliative care specialist8-24 hours (chronic dosing)Severe chronic pain
Morphine30mg oral2-3 hours; 12-24hrs for controlled releaseModerate to severe pain
Oxycodone15-20mg oral3-4 hours; 12-24hrs for controlled releaseModerate to severe pain; preferred in renal impairment (adjust dose)
Tapentadol75-100mg oral12 hours for controlled releaseModerate to severe chronic pain
Codeine (analgesic only)200mg oral3-4 hoursMild to moderate pain; not recommended
Pethidine75-100mg IM2-3 hoursNot recommended
DextropropoxypheneUnknownNot recommended;

Partial agonists#

DrugApprox dose to 10mg IM/SC morphineApprox duration of actionComments
Buprenorphine (analgesic only)0.4mg IM; 0.8mg sublingual6-8 hoursNot first line for analgesia
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Opioid Formulation Table »
  • Agonists
  • Partial agonists
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.