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An example oral opioid switch from morphine to oxycodone

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Topics: MorphineOxycodonePalliative and End of Life CareSwitching

An example scenario to support you when switching or advising on switching between morphine and other oral opioids in cancer and palliative care.

This article forms part of a series
  1. Switching between morphine and other opioids in palliative care
    1. Estimating dose equivalence from oral morphine to other opioids
    2. An example oral opioid switch from morphine to oxycodone
Contents
  1. Using our advice
  2. Scenario: morphine to oxycodone
    1. Calculate current total daily opioid dose
    2. Estimate an equivalent dose
    3. Consider applying a dose reduction
    4. Choose a MR oxycodone preparation
    5. Prescribe as required oxycodone
    6. Monitor patient and titrate doses
  4. Update history

Using our advice

If you have not done so already, refer to the first article in this series before reading this scenario.

Switching between morphine and other opioids in palliative care

Switching between oral morphine and other oral opioids requires care and thoughtful application of a stepped process.

Scenario: morphine to oxycodone

Patient is taking:

  • modified-release (MR) morphine tablets 30mg twice daily
  • morphine oral solution 10mg 4 hourly when required (‘prn’) – patient reports needing to take breakthrough (‘prn’) doses on average twice daily

Their consultant suggests switching morphine to oxycodone.

We have provided an example of how to apply our equivalence advice to determine an appropriate dose of oxycodone for this patient.

Update history

  1. Full review and update complete. Minor changes to structure and wording.
  2. Published
  1. Minor amendments following user feedback

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