Author: MacDonald-N. Der-L. Allan-S. Champion-P.

Title: Opioid hyperexcitability: the application of alternate opioid therapy.

Source: Pain. 1993 Jun. 53(3). P 353-5.

Journal Title: PAIN.

Abstract: Three cases are reported where patients experienced severe central nervous system adverse effects on high-dose hydromorphone. These effects were rapidly alleviated following a change in therapy to morphine at 20-25% of the usually accepted potency equivalent dose. We recommend caution in using equivalent dose tables when changing opioid therapy in patients receiving high-dose opioid treatment.