{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T05:25:25Z","timestamp":1793683525212,"version":"4.5.1"},"reference-count":57,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2011,6,27]],"date-time":"2011-06-27T00:00:00Z","timestamp":1309132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p>In this paper we describe the results of a systematic search of the literature on conversion ratios during opioid switching. This is part of a project of the European Palliative Care Research Collaboration to update the European Association for Palliative Care recommendations for the use of opioid analgesics in the treatment of cancer pain. Studies were eligible for inclusion if they involved adult patients with chronic cancer pain, contained data on opioid conversion ratios, were prospective and were written in English. Thirty-one studies were identified and included. The majority of the studies had methodological flaws and were not designed to explore or demonstrate equianalgesic dose data. However, the data allow some recommendations to be made that could be helpful to clinicians for whom there are few reliable experimental data on which to base dosing guidelines. Switching to transdermal fentanyl (TDfe) or buprenorphine (TDbu) is an option for patients with stable, controlled pain. Reliable and consistent studies show a ratio of 100\u2009:\u20091 between oral morphine (ORmo) and TDfe. A ratio of 75\u2009:\u20091 between ORmo and TDbu may be appropriate, but the supporting evidence here is much less robust. Data are relatively consistent to support a conversion ratio between ORmo and oral hydromorphone (ORhy) of 5\u2009:\u20091. Despite some limitations, there is evidence to support the use of an approximate conversion ratio of ORmo:oral oxycodone (ORox) of 1.5\u2009:\u20091. The conversion between ORox and ORhy is estimated to be 1\u2009:\u20094. When switching from different opioids to methadone the conversion ratio is highly variable, ranging from 5\u2009:\u20091 to 10\u2009:\u20091 and much higher in some studies. The derived ratios are influenced by several factors, including the reasons for switching and previous opioid doses. An individual treatment decision and strict monitoring is recommended for patients considered at risk.<\/jats:p>","DOI":"10.1177\/0269216311406577","type":"journal-article","created":{"date-parts":[[2011,6,27]],"date-time":"2011-06-27T19:45:38Z","timestamp":1309203938000},"page":"504-515","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":163,"title":["Conversion ratios for opioid switching in the treatment of cancer pain: a systematic review"],"prefix":"10.1177","volume":"25","author":[{"given":"Sebastiano","family":"Mercadante","sequence":"first","affiliation":[{"name":"Professor of Palliative Medicine, University of Palermo, Director of Anesthesia and Intensive Care and Pain Relief and Palliative Care, La Maddalena Cancer Center, Via San Lorenzo 312, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto","family":"Caraceni","sequence":"additional","affiliation":[{"name":"Palliative Care, Pain and Rehabilitation Unit, Fondazione IRCCS National Cancer Institute, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2011,6,27]]},"reference":[{"key":"bibr1-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2542"},{"key":"bibr2-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(00)00236-0"},{"key":"bibr3-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(95)90924-C"},{"key":"bibr4-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960815)78:4<852::AID-CNCR23>3.0.CO;2-T"},{"key":"bibr5-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2006.03.001"},{"key":"bibr6-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19991101)86:9<1856::AID-CNCR30>3.0.CO;2-G"},{"key":"bibr7-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903120158"},{"key":"bibr8-0269216311406577","first-page":"CD004847","volume":"3","author":"Quigley C","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr9-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.002"},{"key":"bibr10-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.001"},{"key":"bibr11-0269216311406577","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2001.1680"},{"key":"bibr12-0269216311406577","unstructured":"King S, Reid C, Forbes K and Hanks G. 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