Calculating Conversations About Opioid Conversions: Not Your Mama's Equianalgesic Chart! (FR475)

Abstract

•Describe reasons why patients need to switch from one opioid regimen to a different opioid regimen.•Describe recent data that evaluates including switching from IV hydromorphone to oral hydromorphone, morphine or oxycodone, and other conversions.•Describe considerations for future opioid switching best practices: equivalency vs. utility. It is not uncommon for patients to require switching from one opioid to a different opioid to maximize pain control and minimize adverse effects. This may be due to transitions in care (between acute and chronic care), due to lack of an acceptable therapeutic response, or due to opioid-induced toxicity. Practitioners rely on equianalgesic tables to determine an equivalent dose of a different opioid regimen. Much of the data that supports these tables is from single-dose studies, not steady-state clinical trials, and seldom if ever consider patient-specific considerations. In the past 2-3 years, better evidence has emerged in opioid conversions, including data from stead-state clinical practice. In this presentation participants will learn about this emerging data that demonstrates best practices in switching between opioid and dosage formulations. Using a case-based format, the presenters will guide participants through the application of this data, and use of a "new and improved” equianalgesic table. Last, participants will leave about a new concept of "opioid utility” which may be the next concept in opioid conversions. This presentation will share cutting-edge data that provide more accurate guidance than traditional opioid equianalgesic charts have in years past.