Opioid Rotation: Focus on Safety
EXPERT ANALYSIS FROM THE CONGRESS OF CLINICAL RHEUMATOLOGY
• To convert methadone (20 mg oral dose three times daily) to extended-release oxymorphone:
1. Calculate the total methadone 24-hour dose (60 mg daily).
2. Use mu-agonist dose chart to calculate oxymorphone dose equivalency to methadone (5 mg methadone = 10 mg oxymorphone).
3. Convert the 24-hour methadone dose to oxymorphone dose (60 mg methadone = 120 mg oxymorphone).
4. Reduce the dose by 50% and split the 50% total calculated oxymorphone dosage to a twice-daily dose. Prescribe oxymorphone ER (30 mg oral dose every 12 hours).
Dr. Fine has served as an advisory board member for Ameritox, Covidien, King (now Pfizer), Meda, and Purdue-Pharma. He also is a consultant for Cephalon and Johnson & Johnson.
