Relative
analgesic
ratio
Strength of the
recommendation
for use
Oral morphine to oral oxycodone 1:1·5 Strong
Oral oxycodone to oral hydromorphone 1:4 Strong
Oral morphine to oral hydromorphone 1:5 Weak
Oral morphine to TD buprenorphine* 75:1 Weak
Oral morphine to TD fentanyl† 100:1 Strong
TD=transdermal. *Example: 60 mg oral morphine to 35 μg/h TD buprenorphine
(equivalent to 0·8 mg per 24 h). †Example: 60 mg oral morphine to 25 μg/h TD
fentanyl (equivalent to 0·6 mg per 24 h).
Table 2: Relative analgesic ratios for opioid switching