i'm really sorry about posting several times today but my previous question may be too difficult to amswer? simply put, in a comparison of the most common stronger opiates, where does methadone fall as far as strenght, say for instance compared to oc's, kadian,ms contin,etc. a simple comparison that i would understand is if i'm taking 60 mg's of methadone daily prescribed by my pain doc, what are the equivelents to the others???? i've suffered four complete rotor cuff tears in the last three years, all the same shoulder. waiting for complete reconstruction but my doc tells me this won't eliminate the pain either. most trauma suffered in the same area causes severe arthritis ans if anyone has ever popped a tendon completely you know what type of pain i'm talking about. they've tried to reattach it from partial tears as well over seven times in the last 15 years. most of the humeral bone has been cut off already and the rest is a mess of arthritis. this is to let everyone know why i've been taking my chronic meds.............
I'm some will respond with some good info on switching meds that have prior experience/knowledge. As for me, I can only point you to this converter where you plug in what you are taking and the dose and it'll tell you the conversion. Of course, as everyone will tell you, everyone is different so even the conversions might not be accurate depending on the person.
When I swithed my docs use a 5:1 conversion,After a year on meth at 120mgs per day I went to 600mgs of Kadian, Kadian was dropped by my ins, plan and I went to generic MSC 200mgs TID and after a year on morphine I swithced back to the same 120 mgs of meth where I stayed for another year and a half.
You won't see a 5:1 conversion on anything but the most recent articles that suugest Meth has been underestimated for years and the equianelgesic tables are only acurate for single dose conversion. They do not take into acount the half life and build up of meth for the first 5 days.
Good luck, Dave
This is the conversion Dr Brookoff uses but you have to remeber, these are just guides to get you into the ballpark, they are safe so you won't OD and close enough to prevent withdrawal. But there is no absolute, you would likely still need adjutments unless you able to flip flop back and forth from one to the other.
Table 1. Equianalgesic
Doses of Opioid
This is the Unniversity of washingtons talarian index
Table 11. Dose equivalent for opioid analgesics for opioid-naive children and adults <50 KG BODY WEIGHT  Approximate equianalgesic dose
(MS Contin,Oramorph) =90-120 mg q 12 h
Hydromorphone (Dilaudid) =7.5 mg q 3-4 h
Levorphanol(Levo-Dromoran) =4 mg q 6-8 h
Meperidine(Demerol) = 300 mg q 2-3 h
Methadone(Dolophine, other) =20 mg q 6-8 h
Personally I think If you usd a 1:1 conversion on a partient using 600 mgs of morphine, and went to 600 mgs of methadone you would kill them in on the
There just isn't an absolute answer, There is one more I'll be back to show.
Good luck, Dave
The chart below indicates the
Daily Oral Morphine Dose Equivalents
followed by the
Conversion Ratio of Oral Morphine to Oral Methadone