Template:Parenteral opioids chart

Parenteral Opioid Dosing Chart

DRUG ROUTE DOSAGE COMMENTS
Morphine IV or IM

Titrate 2-5 mg increments q5-10 min

Peak analgesia in 10-20 min

Average: 10 mg q3-4h

Preferred first-line agent in most situations
Fentanyl IV or IM

Titrate 25-50 mcg increments q2-3 min

Peak analgesia in 3-5 min

Duration 30-60 min

Ideal for short procedures

No histamine release

Typically not suitable for the ED

Meperidine

(Demerol)

IV

Titrate 12.5-50 mg increments

Peak analgesia in 5-10 min

Average: 100 mg q2-3h

Risk of unique CNS toxicity with repeated dosing

IM injection is very irritating to tissue

Hydromorphone

(Dilaudid)

IV

Titrate 0.5-1.0 mg increments

Peak analgesia in 5-15 min

Average: 1.5 mg q3-4h

Butorphanol

(Stadol)

IV

Titrate 0.5-2.0 mg increments

Peak analgesia in 4-5 min

Average: 2 mg q3-4h

Mixed agonist-antagonist

May be preferred in biliary colic