Common reasons for switching:
- Current opioid not helping the pain
- Current opioid causing toxic symptoms (hallucinations, twitching, sedation)
- Need an alternative route eg a patch because of vomiting or poor swallow
ALWAYS check a conversion dose with a colleague, especially if unfamiliar with opioids
This Opioid dose conversion chart is from Royal United Hospitals Bath:
West Midlands CARES website has in depth advice about switching opioids and caveats to looks out for including renal function, age, dose, weight etc.
An online Opioid Dose Calculator is also available on the PANG Palliative Guidelines website