Approximate oral equianalgesic doses for commonly used opioids

Drug	Approximate equivalent doses (oral immediate-release preparations)	Approximate equianalgesic dose ratio (morphine:alternate opioid)
Codeine*	200 mg	1:7
Fentanyl	No oral equivalent
Hydrocodone	30 mg	1:1
Hydromorphone	7.5 mg	4:1
Morphine	30 mg	1:1 (reference standard)
Oxycodone	20 mg	1.5:1
Oxymorphone	10 mg	3:1
Tapentadol	75 mg	0.4:1
Tramadol	300 mg	0.2:1

Equianalgesic conversions serve only as a general guide to estimate opioid dose equivalents. For a review of multiple factors that must be considered for safely individualizing conversion of opioid analgesia, refer to UpToDate topics on the use of opioids for acute and chronic pain.

* Generally not recommended due to high variability in response.

Adapted from: Dowell D, Ragan KR, Jones CM, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022. MMWR Recomm Rep 2022; 71:1.

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Approximate oral equianalgesic doses for commonly used opioids