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Medicine

Opioid Rotation and Equianalgesic Dosing in Chronic Pain Management

Quick fact

Equianalgesic conversion tables are not a one-to-one exchange: because of incomplete cross-tolerance, starting the new opioid at the calculated equivalent dose can cause respiratory depression and death—hence the '25–50% reduction' rule in clinical guidelines.

Why this is interesting

You've been on one opioid for years, it stops working, and the dose keeps creeping up—yet your pain gets worse. What if the solution isn't another pill of the same drug, but a completely different one?