Opioid comparison
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Opioid comparison
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Opioids are a class of compounds that elicit analgesic (pain killing) effects in humans and animals by binding to the μ-opioid receptor within the central nervous system. The following table lists commonly used opioid drugs and their relative potencies. Values for the potencies of opioids listed on this table are given as taken orally unless another route of administration is provided. As such, their bioavailabilities differ, and they may be more potent when taken intravenously. Methadone is different from most opioids considering its potency can vary depending on how long you take it. Acute use; 1-3 days, yields a potency about 4x stronger than that of Morphine and Chronic use (7 days+) yields a potency about 7-8x that of morphine due to methadone being stored in fat tissue, thus giving higher serum levels with longer use.
| Analgesic/opioid | Strength[1] (morphine) | Equivalent dose (10 mg morphine) | Bioavailability | Half-life of active metabolites (hours) |
|---|---|---|---|---|
| Aspirin (non-opioid) | 1/360 | no equivalent dose | total | 3.1–9 |
| Diflunisal (NSAID, non-opioid) | 1/160 | 1600 mg | 80–90% | 8–12 |
| Propoxyphene[2] | 1/13 to 1/20 | 130-200 mg | ||
| Codeine | 1/20 | 200 mg | ≈90% | 2.5–3 (C6G 1.94;[3] morphine 2–3) |
| Tramadol | 1/10 | 100 mg | 68–72% | 5.5–7 (≈9)[clarification needed] |
| Anileridine[4] | 1/4 | 40 mg | ||
| Pethidine | 0.36 | 28 mg | 50–60% | 3–5 |
| Hydrocodone | 0.6 | 17 mg | ≥80% | 3.8–6 |
| Morphine (oral) | (1) | (10 mg) | ≈25% | 2–3 |
| Oxycodone | 1.5–2.0 | 5.0–6.7 mg | ≤87% | 3–4.5 |
| Methadone (acute) [5] [6] | 3-4 | 2.5-3.33 mg | 40–90% | 15–60 |
| Morphine (IV/IM) | 4 | 2.5 mg | 100% | 2–3 |
| Diamorphine (Heroin; IV/IM)[7] | 1.9–4.3 | 2.3–5.2 mg | 100% | <0.6 |
| Hydromorphone[8] | 5 | 2 mg | 30–35% | 2–3 |
| Oxymorphone | 7 | 1.4 mg | 10% | 7.25–9.43 |
| Methadone (chronic) [9] | 7.5 | 1.35 mg | 40-90% | 15-60 |
| Levorphanol[10] | 8 | 1.3 mg | 70% | 11–16 |
| Buprenorphine[11][not in citation given] | 40 | 0.25 mg | 35–40% (sublingual) | 20–70, mean 37 |
| Fentanyl | 50–100 | 0.1–0.2 mg | 33% (oral); 92% (transdermal) | 0.04 (IV); 7 (transdermal) |
| Sufentanyl | 500–1,000 | 10–20 μg | 4.4 | |
| Etorphine[12] | 1,000–3,000 | 3.3–10 μg | ||
| Carfentanil 10 | 10,000–100,000 | 0.1–1.0 μg | 7.7 |
See also
- Oripavine – for more on the comparative strength of oripavine derivatives
Notes
- ^ In simple terms, analgesic "strength" in this table means how much more or less potent the indicated drug is compared to morphine. The values can be used to calculate approximately equivalent dosages of different opioids. Because some of these compounds (for example, codeine and tramadol, but not morphine) are prodrugs, differences amongst people in their liver enzymes (such as the cytochrome P450 enzyme CYP2D6) may result in a significantly altered drug effect
- ^ http://www.dea.gov/pubs/abuse/4-narc.htm
- ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867071/
- ^ http://designer-drugs.com/pte/12.162.180.114/dcd/chemistry/anileridine.html
- ^ http://www.psicofarmacos.info/images/graficos/Tabla4_opiaceos.JPG
- ^ http://www.jaoa.org/content/105/3_suppl/18S/T2.expansion.html
- ^ Claus W. Reichle, Gene M. Smith, Joachim S. Gravenstein, Spyros G. Macris and Henry K. Beecher. Comparative analgesic potency of Heroin and Morphine in postoperative patients [1]
- ^ http://www.palliative.org/PC/ClinicalInfo/PCareTips/MorphineVSHydromorphine.html
- ^ http://www.jaoa.org/content/105/3_suppl/18S/T2.expansion.html
- ^ http://redpoll.pharmacy.ualberta.ca/drugbank/cgi-bin/getCard.cgi?CARD=APRD00764.txt
- ^ http://www.dea.gov/pubs/abuse/4-narc.htm
- ^ Because of their extreme potency, etorphine, carfentanil, and other similarly powerful opiates are only used for the sedation of large animals. Sufentanil is the strongest opioid used in human medicine.
References
- Opioid Comparison
- Clinical Practice Guideline for the Management of Opioid Therapy for Chronic Pain
- Opioids in The Treatment of Acute Low Back Pain
- Pharmacokinetics of acetaminophen, codeine, and the codeine metabolites morphine and codeine-6-glucuronide in healthy Greyhound dogs
- Considerations of dextropropoxyphene-containing medicines under Section 36 of the Medicines Act 1981
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