Opioid Conversion - A Slightly "tricky" case. Any help pls?

[Dagswe21]

Hello everyone.

first up, I'm new to these forums. This is my first ever post. If I make any Forum Mistakes, please note that these are absolutely, not intended. I am 'learning the ropes', so I apologise beforehand if I make any mistakes. They would not be repeated, if pointed out to me!! Thanks.

Ok. This looks like an easy case of Opioid Conversion, but, despite a number of google searches, I cannot get a definitive answer, that is confirmrmed somewhere else! I'm sure for someone on here it will be very easy, so ANY help would be of Massive use:

I need to convert:

Taking OxyNorm (NOT Conti), total 90mg per day approx, (in the form of oral syrup/liquid), in 4 or 5 doses. How would this be convefrted to taking Morphine ER (Slow Release) oral tablets, 30mg each? This person IS Opioid-tolerant (having used Fentanyl patches at much higher doses) so the answer doesn't need to be absolutely precise. More, a rough estimate of how many Morphine ER 30mg Oral tablets in 24hrs.

PLS bear in mind, this is going from an immediate release, to a slow release, product. I think this is why it is proving tricky to get a good answer!!

Dagswe21 (or just 'dag' for short!).

Thanks in advance,

dag.

 

[Relapz]

30 mg of morphine is equal to about 20 mg of oxycodone, so 90 mg of oxycodone would have the equivalent dose of 130-140mg of morphine.

so around 4 morphine pills and half of one.

 

[Jekyl Anhydride]

You should also prepare yourself for the fact that MS (especially ER) can be a very underwhelming high as compared to oxycodone. You might have to let it accumulate for a couple of days to gain the relief that the oxy provides. You might consider replacing the oxy with MS over a few days to make the transition easier. Eg. 60mg of oxy & 45 of MS on day one, 30mg of oxy & 90mg of MS on day 2, then the jump to 120-140mg of MS. All spread throughout the day of course and adjusted down if sedation becomes a factor.
I only mention this because when I switched to MS from oxy I thought it wasn't working. I ended up taking higher doses than I should have of the MS till I became familiar with the effects, but as Relapz stated 4 -4 1/2 30mg pills should hold you.

 

[Ilove2nod]

Dag: Did you make this choice to switch from oxy to MS? IME I have to say, I HATE MS contin, it is practically useless to me, compared to oxy! Very, very weak when taken orally, IMO even weaker than what the conversion charts would say.. At least when taken oral or intranasal... it has a very poor oral BA, unlike oxy, which has a very good oral BA.. and if you IV, which is basically the only way morphine is any good, these are nearly impossible, to safely prep and shoot... If there is any way to stay on your oxy, I would stay on it and not switch to MS contin.. I am pretty sure, if you are at all opioid tolerant, you wont feel a thing from 30mg MS contin tablets, taken oral.. Plugging them? Maybe! I have heard, morphine taken rectally or plugged, is better than oral and sniffing it, but not as good as IV/IM, and falls somewhere in between.. so I wouldn't have made this switch, as I am just assuming these are prescriptions, judging by the way you posted this.. I think you will either be totally disappointed with the MS contin and go back to the oxy norm syrup, or possibly be screwed and stuck with the morphine? I don't know all depends on you and your docs relationship, if again you are reffering to your meds? This is just my opinion, the only time I have EVER felt anything from morphine, it was from morphine IR tabs, done IV.. that was nice! but I am in no way, condoning you pick up the bad habit of injecting pills, like I did, and wish I never had done! Hope you figure it out.. and can make the MScontin work for you, I couldn't...