Tilidine/Naloxone conversion reference
Check OpioidCalc's OME factors by route, then open the formulation-specific pharmacology, cautions and supporting sources.
Educational reference for qualified healthcare professionals. Conversion factors estimate oral morphine equivalent daily dose. They are not a recommended switching dose. Confirm the result with a current source and local guidance.
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Current OpioidCalc factors
Multiply the dose or delivery rate in the stated units by the factor to estimate mg oral morphine equivalent per day. These are the factors currently used by OpioidCalc. Methadone uses 4.7 when converting methadone to OME.
| Route | Input units | OME factor |
|---|---|---|
| Oral | mg/day | 0.1 |
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Formulations and cautions
Choose a formulation to read its pharmacology, population, limitations and source references.
OralImmediate-release oral drops
App source review: 27 August 2026
View details and sources
Immediate-release oral drops
App source review: 27 August 2026
View details and sources- Onset
- 10 to 15 minutes
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.1 Pharmacodynamic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Peak concentration or effect
- Approximately 25 to 50 minutes
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.1 Pharmacodynamic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Duration
- 4 to 6 hours
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.1 Pharmacodynamic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Elimination half-life
- Nortilidine 3 to 5 hours; naloxone and metabolites 3 to 4 hours
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Tilidine is a weak opioid prodrug; nortilidine is the principal active opioid. Naloxone is an antagonist.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.1 Pharmacodynamic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP3A4 and CYP2C19 form active nortilidine, followed by inactive bisnortilidine.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Active metabolites
- Nortilidine is the principal active metabolite.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Elimination
- Metabolised products are predominantly eliminated in urine.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Renal impairment
- The product information states that pharmacologically active metabolites do not accumulate in renal dysfunction.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Hepatic dysfunction can reduce nortilidine exposure and increase systemic naloxone.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin AbZ Tropfen Fachinformation4.4 and 5.2. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
OralDefault in appModified-release tablet
App source review: 27 August 2026
View details and sources
Modified-release tablet
App source review: 27 August 2026
View details and sources- Elimination half-life
- Apparent half-life of active nortilidine and naloxone metabolites approximately 5.5 hours
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Formulation behaviour
- Every-12-hour prolonged release; crushing or splitting defeats the modified-release mechanism.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Do not inherit the drops' onset or duration.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation4.2 and 5.2. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Receptor activity
- Tilidine is a weak opioid prodrug; nortilidine is the principal active opioid. Naloxone is an antagonist.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.1 Pharmacodynamic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Metabolism
- CYP3A4 and CYP2C19 form active nortilidine, followed by inactive bisnortilidine.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Active metabolites
- Nortilidine is the principal active metabolite.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Elimination
- Metabolised products are predominantly eliminated in urine.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Renal impairment
- The product information states that pharmacologically active metabolites do not accumulate in renal dysfunction.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation5.2 Pharmacokinetic properties. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
- Hepatic impairment
- Hepatic dysfunction can reduce nortilidine exposure and increase systemic naloxone.
Population: Adults described in the cited product information
Applicability: Germany
- Limitation: Product-specific evidence; do not transfer to other formulations.
- Tilidin-ratiopharm plus Retardtabletten Fachinformation4.4 and 5.2. Germany. Source revised 1 September 2020. App review 27 August 2026. Regulatory product information.
Sources used on this page
Other medicine references
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