Oxycodone oral estimate
Uses a 3.0 multiplier for oral methadone only.
- Raw oxycodone oral dose
- 20 mg/day
- Safety reduction applied
- 0% reduction
- Renal-adjusted target
- Not applied
- Hepatic-adjusted target
- Not applied
- Organ guidance summary
- No renal or hepatic class selected
No renal band selected
Enter eGFR to turn on the renal adjustment guidance.
No hepatic class selected
Select mild, moderate, or severe hepatic impairment to show the configured liver dosing guidance for the target opioid.
| Drug and route | Regimen | Daily totals |
|---|
Before ordering
- Multi-drug totals are intended for regimen-level review; they do not replace opioid-specific bedside assessment.
- Patch entries are treated as standing 24-hour exposure estimates and not as initiation or titration instructions.
- Methadone totals are especially approximate; use the methadone tab and specialist input when rotating to methadone.
- Renal and hepatic cards show configured guidance and local advisory rules; they are not validated severity scores.
- Reassess analgesia, respiratory rate, sedation, organ function, and adverse effects after conversion.
Methadone result
Conservative starting estimate
- Morphine:methadone ratio
- 8:1
- Raw oral methadone
- 12.5 mg/day
- Route adjustment
- Oral route
- Reduction applied
- 0% reduction
- If divided q8h
- 4.17 mg/dose
- If divided q12h
- 6.25 mg/dose
Methadone cautions
- Use only with clinician experience or pain/palliative specialist input.
- Methadone requires slow titration to the intended dose due to its long and variable half-life and risk of accumulation; if you are not comfortable or experienced with methadone, please consult a pain or palliative care specialist.
- Account for long and variable half-life, delayed toxicity, QTc risk, CYP interactions, and renal/hepatic context.
- No automatic rounding to tablet or liquid formulation is performed.
Schedule
30-59 mg MEDD
| Day | Full agonist | Buprenorphine |
|---|
Buprenorphine transition cautions
- Confirm the MEDD range, diagnosis, formulation access, and payer constraints before using this schedule.
- Belbuca and Suboxone both contain buprenorphine, but they are different formulations with different dose units and administration routes.
- Monitor for withdrawal, oversedation, respiratory depression, worsening pain, and adherence during cross-titration.
- For MEDD above 300 mg/day or unstable patients, consult pain, palliative care, or addiction medicine.
Reference Configured tables and sources Open when you need to audit the configured tables.
Reference
Configured equianalgesic values used
| Medication | Route | Reference dose | Oral morphine equivalent | Use |
|---|
This calculator uses a configured hybrid table: current local morphine and hydromorphone relationships are preserved, while hydrocodone, codeine, oral methadone, and expanded fentanyl patch entries are updated to the configured values.
Hepatic
Configured hepatic adjustment guide
| Medication | Mild | Moderate | Severe |
|---|
Renal logic configured in this calculator: eGFR above 50 mL/min uses no automatic reduction; eGFR 30-50 mL/min applies a 25% reduction for uncontrolled pain or 50% for well controlled pain to morphine, codeine, and meperidine; eGFR below 30 mL/min marks morphine, codeine, and meperidine as avoid and highlights oxycodone or hydromorphone as moderate-kidney-effect alternatives and methadone, fentanyl, or buprenorphine as minimal-kidney-effect alternatives.
Sources
References used to build this table
| Source | How it is used here | Link |
|---|