Buprenorphine (subutex) to oral morphine sulfate equivalency

[bigzip44]

What is sixteen milligrams of sublingual buprenorphine (subutex) equalavent to in milligrams of oral morphine sulfate? Also, is there a difference between IR and ER in doing a conversion. I apologize if this has been asked and answered but I have searched long and hard and have had an impossible time finding a truly accurate answer and I thought I would give the smart guys in pharmacology a try. Thanks. Much appreciated.

 

[bigzip44]

Oh, sorry, I didn't mention that the sixteen milligrams is taken daily and long term; also I don't or cannot account for cross-tolerance because I don't know what that would be but I am not, clearly, opiate naive. Thanks again and please ask if there are any questions that would be helpful in answering this question of mine.

 

[ebola?]

It is difficult to put forth a straightforward equivalence, because you have different affinities at various opioid receptor subtypes, but also because bupe' is a partial agonist at mu. Different people will find different levels of equivalence. Also, morphine isn't very orally bioavailable, so route of admin matters a lot.

This isn't really within the scope of this forum. I'll move this to basic drug discussion.

ebola

 

[sekio]

16mg of bupe is... a lot. I think the equianalgesic ratio is something like 0.1mg bupe to 10mg morphine, at least at lower doses. Because bupe is a partial agonist with nonlinear pharmacokinetics (depending on dose size, a variable amount is turned to the full agonist norbuprenorphine).

Are you trying to switch from buprenorphine to morphine? I would just start at 30mg plugged/snorted and see. You can always take more but not less. (Don't take 160mg morphine right off the bat.) All the full agonist opioids at appropriate doses will "feel" more potent than bupre because they cause more receptor activation.