Clinical Pharmacology
Reference guide for pharmacokinetics, metabolism, and clinical considerations.
Equianalgesic Reference
10mg Parenteral ≈ 30mg Oral
Mechanism of Action
Full agonist, primarily at the mu-opioid receptor (MOR) in the CNS and PNS. Also has affinity for delta (DOR) and kappa (KOR) receptors.
Brand Names
Equianalgesic Reference
20mg Oral ≈ 30mg Oral Morphine
Mechanism of Action
Agonist at mu, kappa, and delta opioid receptors, with the strongest affinity for mu receptors.
Brand Names
Equianalgesic Reference
1.5mg Parenteral ≈ 7.5mg Oral ≈ 10mg Parenteral Morphine
Mechanism of Action
Potent full agonist, primarily acting on mu-opioid receptors. More lipid-soluble than morphine.
Brand Names
Equianalgesic Reference
30mg Oral ≈ 30mg Oral Morphine
Mechanism of Action
Selective full agonist of the mu-opioid receptor. Also acts centrally as an antitussive.
Brand Names
Equianalgesic Reference
0.1mg (100mcg) Parenteral ≈ 10mg Parenteral Morphine
Mechanism of Action
Potent mu-opioid receptor agonist.
Brand Names
Equianalgesic Reference
Complex, dose-dependent conversion.
Mechanism of Action
Racemic mixture. (R)-enantiomer: Mu-opioid receptor agonist. (S)-enantiomer: NMDA receptor antagonist and inhibitor of serotonin/norepinephrine reuptake.
Brand Names
Equianalgesic Reference
200mg Oral ≈ 30mg Oral Morphine (Highly variable)
Mechanism of Action
Weak mu-opioid receptor agonist. Antitussive effect via direct action on the medulla.
Brand Names
Equianalgesic Reference
120mg Oral ≈ 30mg Oral Morphine (Variable)
Mechanism of Action
Weak mu-opioid receptor agonist (parent drug and M1 metabolite). Inhibitor of serotonin and norepinephrine reuptake (SNRI).
Brand Names
Equianalgesic Reference
100mg Oral ≈ 20mg Oral Morphine (approx)
Mechanism of Action
Mu-opioid receptor agonist and Norepinephrine Reuptake Inhibitor (NRI). Minimal serotonin reuptake inhibition.
Brand Names
Equianalgesic Reference
1mg Parenteral ≈ 10mg Oral ≈ 10mg Parenteral Morphine
Mechanism of Action
Potent agonist, primarily acting on mu-opioid receptors.
Brand Names
Equianalgesic Reference
Conversion varies significantly by formulation and indication.
Mechanism of Action
Partial agonist at the mu-opioid receptor (high affinity, low intrinsic activity) and antagonist at the kappa-opioid receptor.
Brand Names
Equianalgesic Reference
5-10x more potent than Fentanyl (10-20mcg Parenteral ≈ 10mg Parenteral Morphine)
Mechanism of Action
Extremely potent mu-opioid receptor agonist. Highly lipophilic.
Brand Names
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