Caution, Vigilance, and Personalization: A Must for Any Opioid Conversion

It is with great enthusiasm that we read the letter written by Foxwell and Uritsky in response to our study "The Conversion Ratio from Intravenous Hydromorphone to Oral Opioids in Cancer Patients".1 Our study concluded after retrospectively reviewing the charts of 394 cancer patients that 1mg of intravenous (IV) hydromorphone is equivalent to 2.5 mg of oral hydromorphone and 11.46 mg of morphine equivalent daily dose (MEDD). A ratio of 1:2 from IV to oral hydromorphone was recommended in patients receiving high doses of IV hydromorphone.

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