ArticleJournal of pain and symptom management2017
The Conversion Ratio From Intravenous Hydromorphone to Oral Opioids in Cancer Patients.
Article in Journal of pain and symptom management, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 49 citations in OpenAlex.
- Evaluation of Quality of Life Outcomes Following Palliative Treatment of Bone Metastases with Magnetic Resonance-guided High Intensity Focused Ultrasound: An International Multicentre Study.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2018Trial
- Article
- Inadequate Cancer Pain Control after Switching High-Dose Fentanyl to Hydromorphone Injection: A Case Series Highlighting Issues with Conventional Conversion Ratios.Palliative medicine reports · 2025Article
- Early detection of patients with narcotic use disorder using a modified morphine equivalent daily dose score based on an analysis of real-world prescription patterns: a retrospective cohort study.Ewha medical journal · 2024Article
- Analgesic efficacy of surgeon placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective non-inferiority study.Journal of thoracic disease · 2024Article
- Preoperative transversus abdominis plane block decreases intraoperative opiate consumption during minimally invasive cholecystectomy.Surgical endoscopy · 2023Article
- Altered Membrane Expression and Function of CD11b Play a Role in the Immunosuppressive Effects of Morphine on Macrophages at the Nanomolar Level.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Identification of Factors Contributing to Methadone-Induced Daytime Sleepiness in Cancer Patients and Proposal of the Conversion Ratio from Other Opioids to Oral Methadone: A Retrospective Cohort Study.Palliative medicine reports · 2023Article
- A Comparison of Institutional Opioid Equianalgesia Tools: A National Study.Journal of palliative medicine · 2022Article
- Opioid Rotation and Conversion Ratios Used by Palliative Care Professionals: An International Survey.Journal of palliative medicine · 2022Article
- Effects of high-dose opioid analgesia on survival, pain relief, quality of life and adverse drug reactions in cancer and neuropathic pain patients: a retrospective cohort study in real-world clinical practice.Annals of translational medicine · 2022Article
- 3-T magnetic resonance-guided high-intensity focused ultrasound (3 T-MR-HIFU) for the treatment of pain from bone metastases of solid tumors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Postoperative Respiratory Events in Surgical Patients Exposed to Opioid Analgesic Shortages Compared to Fully Matched Patients Non-exposed to Shortages.Drug safety · 2022Article
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- Article
- Early ventilator liberation and decreased sedation needs after tracheostomy in patients with COVID-19 infection.Trauma surgery & acute care open · 2021Article
- Reducing High-Dose Opioid Prescribing: State-Level Morphine Equivalent Daily Dose Policies, 2007-2017.Pain medicine (Malden, Mass.) · 2020Article
- Impact of Patient-Controlled Analgesia (PCA) Smart Pump-Electronic Health Record (EHR) Interoperability with Auto-Documentation on Chart Completion in a Community Hospital Setting.Pain and therapy · 2019Article
- Comparison of Imaging Changes and Pain Responses in Patients with Intra- or Extraosseous Bone Metastases Treated Palliatively with Magnetic Resonance-Guided High-Intensity-Focused Ultrasound.Journal of vascular and interventional radiology : JVIR · 2019Article
- The effects of adding local infiltration analgesia of the knee to a multimodal pain protocol for total arthroplasty: A matched pair retrospective study.Canadian journal of pain = Revue canadienne de la douleur · 2019Article
Corrections and comments
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Authors and funding
20 authors at 3 institutions in 3 countries.
Funding
Abstract
contextThe lack of knowledge of the accurate conversion ratio (CR) between intravenous (IV) and oral hydromorphone and opioid rotation ratio (ORR) between IV hydromorphone and oral morphine equivalent daily dose (MEDD) may lead to poorly controlled pain or overdosing in cancer inpatients.
objectivesWe aimed to determine the CR and ORR from IV hydromorphone to oral hydromorphone and MEDD (obtained from oral morphine and oxycodone).
methodsA total of 4745 consecutive inpatient palliative care consults during 2010-14 were reviewed for conversions from IV hydromorphone to oral hydromorphone, morphine or oxycodone. Patient characteristics, symptoms, and opioid doses were determined in patients successfully discharged on oral opioids without readmission within one week. Linear regression analysis was used to estimate the CR or ORR between the 24 hour IV hydromorphone mg dose before conversion and the oral opioid mg dose used before discharge.
resultsAmong 394 patients on IV hydromorphone, 147 underwent conversion to oral hydromorphone and 247 underwent rotation to oral morphine (163) or oxycodone (84). The median (interquartile range) CR from IV to PO hydromorphone was 2.5 (2.14-2.75) with correlation of 0.95 (P < 0.0001). The median ORR (interquartile range) from IV hydromorphone to MEDD was 11.46 (9.84-13.00) with correlation of 0.93(P < 0.0001). The median ORR was 11.54 in patients receiving <30 mg of IV hydromorphone/day and 9.86 in patients receiving ≥30 mg (P = 0.0004).
conclusionOur study found that 1 mg of IV hydromorphone is equivalent to 2.5 mg of oral hydromorphone and 11.46 mg of MEDD. Hydromorphone at doses ≥30 mg/day may require a lower ORR to other opioids.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.