Drug
|
Dose (mg)
equianalgesic to
10 mg I.M. morphine
I.M. Oral(P.O.)
|
I.M./P.O.
Potency
|
Half Life
[hr]
|
Comments
|
| Codeine |
130 |
200 |
2 |
2-3 |
Usually combined with a nonopioid.
Biotransformed in part to morphine (10%) |
| Propoxyphene |
N/A |
50 |
N/A |
2-3 |
Usually combined with nonopioid.
Norpropoxyphene (metabolite) accumulation with
renal impairment may cause seizures
(Brand names: Darvon, Darvocet, etc.) |
| Hydrocodone |
20 |
40 |
2 |
3-4 |
Usually combined with a nonopioid.
(Brand names: Vicodin, Lorcet, Anexsia, etc.) |
| Oxycodone |
15 |
30 |
2 |
2-3 |
Usually combined with a nonopioid
(Brand names: Percocet, Tylox, Roxicet, etc.
[Oxycodone only: Roxicodone]) |
| Morphine |
10 |
60 |
6 |
2-3 |
Morphine-6-glucuronide in renal failure may predispose
to additional toxicity. Wide range of formulations.
On World Health Organization essential drug list |
| Diamorphine (Heroin) |
5 |
N/A |
6-10 |
0.05 |
Biotransformed completely to morphine and
6-monoacetylmorphine, which are responsible
for analgesic activity. |
| Hydromorphone |
1.5 |
7.5 |
5 |
2-3 |
(Brand name: Dilaudid) |
| Methadone |
10 |
20 |
2 |
15-190 |
Plasma accumulation may lead to delayed
toxicity (oversedation).
(Brand names:
Dolophine, Physeptone, etc.) |
| Meperidine (Pethidine) |
75 |
300 |
5 |
2-3 |
Normeperidine (metabolite) toxicity limits utility. Contraindicated in patients
with renal failure and those receiving monoamine
oxidase (MAO) inhibitors
(Brand name: Demerol) |
| Oxymorphone |
1 |
10 (rectal) |
N/A |
2-3 |
No oral formulation available. Less histamine
release than other opioids.
(Brand name: Numorphan) |
| Levorphanol |
2 |
4 |
2 |
12-15 |
Plasma accumulation may lead to oversedation.
(Brand name: Levo-Dromoran) |
| Fentanyl |
0.1 (100 micrograms) |
N/A |
N/A |
2-3 |
Transdermal patches deliver 25, 50, 75, and 100
micrograms/hr
Administered intravenously for general anaesthesia
(usually as an adjunct to other drugs) in doses as high as
3 mg or more.
(Brand names: Sublimaze, Duragesic) |
| Pentazocine |
60 |
180 |
3 |
2-3 |
Mixed agonist-antagonist. May cause psychotomimetic
effects. May precipitate withdrawal in narcotic-dependent
individuals.
(Brand name: Talwin) |
| Butorphanol |
2 |
N/A |
N/A |
3-4 |
Available as nasal spray for migraine headache.
Mixed agonist-antagonist similar to pentazocine.
(Brand name: Stadol) |
| Buprenorphine |
0.4 |
0.6 (sublingual) |
N/A |
? |
No oral formulation available in U.S.
Partial opioid agonist. May precipitate withdrawal in
narcotic-dependent individuals. Does not produce psychotomimetic effects.
(Brand names: Temgesic, Buprenex, Subutex) |