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Opioid Conversion
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Levy’s Rule
Levy’s Rule
Levy’s Rule
Levy’s Rule to convert from oral morphine to transdermal fentanyl
The fentanyl patch strength in micrograms is equal to half of the total dose of sustained release morphine given over 24 hours.
Source:
Levy M
. Pharmacologic treatment of cancer pain. N Engl J Med 1996;335:1124-32.
Levy’s Rule: Example 1 – Mr. John Smith, a terminally ill, lung cancer patient.
Levy’s Rule: Example 2 – Mr. Tom Hack, a terminally ill, colon cancer patient.
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Opioid Conversion
Pre-Test
General Guidelines
Opioids
Equivalency Table
Equianalgesic Doses
Land Mines
Teaching Exercise 1:
Converting from oral to parenteral morphine
The Case Continues
Teaching Exercise 2:
Converting from oral morphine to fentanyl transdermal patch
Opioid Conversion Tutorial
Levy’s Rule
Example 1
Example 2
Pearls
Resources
Appendices
How to institute opioid therapy
Communication with patients and family on pain treatment
Parenteral to oral conversion ratios of common opioids
Facts about the fentanyl transdermal patch
Using opioid infusions to palliate pain
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