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TAPENTADOL DOSE CONVERSION CHART

Doses in this conversion chart are approximate equivalent doses only. Caution is always necessary. It should be noted that these equivalent doses relate to equivalence and not equivalence due to the dual mechanism of action of tapentadol (mu- and noradrenaline reuptake inhibitor). When converting from one strong opioid to another it is important to: take account of the clinical condition of the patient; consider a dose reduction; review after 24 hours and titrate accordingly.

Route of administration Oral Tapentadol(1) Drug total daily dose total daily dose total daily dose Equivalent Doses 40mg<=> 100mg<=> 20mg<=> 80mg<=> 200mg<=> 40mg<=> 120mg<=> 300mg<=> 60mg<=> 160mg<=> 400mg<=> 80mg<=> 200mg<=> 500mg<=> 100mg<=> (1) Tapentadol m/r is restricted to patients unable to tolerate morphine m/r under the direction of the Pain Clinic. Total daily doses of tapentadol greater than 500mg have not been studied and are therefore not recommended.

Opioid Formulations and Strengths Preparations Morphine (oral) Tapentadol (oral) Oxycodone (oral) Liquid 10mg/5mL oral solution 5mg/5mL oral solution

100mg/5mL concentrated oral solution 10mg/1mL concentrated oral solution Not recommended - 50mg and 75mg tablets are Immediate Release 10mg, 20mg, 50mg tablets 5mg, 10mg, 20mg capsules available but not approved by SMC.* Modified Release 12-hourly tablets: 5mg, 10mg, 15mg, 12-hourly tablets: 50mg, 100mg, 150mg, 200mg, 12-hourly tablets: 5mg, 10mg, 15mg, 20mg, 30mg, 60mg, 100mg, 250mg 30mg, 40mg, 60mg, 80mg, 120mg 200mg

12-hourly suspension (sachet of granules to mix with water): 20mg, 30mg, 60mg, 100mg, 200mg

*Tapentadol immediate release can only be used under specialist direction where an Individual Patient Treatment Request (IPTR) has been approved. Caution: tapentadol immediate-release tablets do not allow an appropriate breakthrough dose at total daily doses of tapentadol below 300mg.

Reference: Personal communication. Grunenthal Ltd. 18/10/11.