{"id":362,"date":"2010-12-16T16:59:53","date_gmt":"2010-12-16T23:59:53","guid":{"rendered":"https:\/\/hartleymedical.com\/blog\/?p=362"},"modified":"2015-06-23T21:47:21","modified_gmt":"2015-06-24T04:47:21","slug":"pharmacology-review-morphine-conversion-to-fentanyl","status":"publish","type":"post","link":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/","title":{"rendered":"Pharmacology Review: Morphine conversion to Fentanyl"},"content":{"rendered":"<p>Morphine is considered the gold standard of therapy for treatment of acute and chronic pain. In regards to intrathecal drug therapies, most physicians will trial their patients on morphine and subsequently institute appropriate measures.<\/p>\n<p>In conditions where morphine is not acceptable or is not yielding the desired clinical effects, clinicians will consider changing to fentanyl citrate. When doing so, it is important to carefully consider both potency and characteristics.<\/p>\n<p>Fentanyl differs from morphine both in regard to clinical response as well as pharmacological characteristics. Morphine is hydrophilic, and fentanyl is very lipophilic, and there is the issue of potency. There is concern among clinicians about changing from morphine to fentanyl because of the fact that fentanyl is demonstrably more potent: in acute pain 100 times more potent and 50 times more potent for chronic pain than morphine.<\/p>\n<p>Due to fentanyl&#8217;s lipophilic properties, the distribution of this drug is more focal as related to the catheter tip.\u00a0 Tissues within the intrathecal space are very (dense in fat, fat saturated, fatty), with a great capacity for absorbing fentanyl, consequently, fentanyl does not travel significantly within the intrathecal space.<\/p>\n<p>Once the decision has been made to change therapies, I recommend a 1 to 25 conversion rate. Although the &#8220;textbook&#8221;\u009d conversion recommendation for chronic pain is 1 to 50, I consider that to be too conservative, based upon the comparative characteristics of the drugs themselves. A 1 to 25 rate is <em>still<\/em> conservative&#8221;\u00a6but I strongly suggest that physicians achieve their own comfort zone as they gain experience with the conversion process. And, of course, weigh the individual differences and concerns of each patient when determining what conversion level will best serve.<\/p>\n<p>For more drug reviews, visit Hartley Medical&#8217;s <em><strong>Knowledge Center<\/strong><\/em> by clicking <a href=\"https:\/\/hartleymedical.com\/category\/drug-reviews\/\">here<\/a>.<\/p>\n<p><a href=\"https:\/\/hartleymedical.com\/knowledge-center\/\"><img decoding=\"async\" class=\"alignleft size-medium wp-image-1158\" title=\"knowledgecenter\" src=\"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg\" alt=\"\" width=\"300\" height=\"39\" srcset=\"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg 300w, https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-1024x135.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Morphine is considered the gold standard of therapy for treatment [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical\" \/>\n<meta property=\"og:description\" content=\"Morphine is considered the gold standard of therapy for treatment [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/\" \/>\n<meta property=\"og:site_name\" content=\"Hartley Medical\" \/>\n<meta property=\"article:published_time\" content=\"2010-12-16T23:59:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2015-06-24T04:47:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/hartleymedical.com\/wordpress\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg\" \/>\n<meta name=\"author\" content=\"William Stuart\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"William Stuart\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/\",\"url\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/\",\"name\":\"Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical\",\"isPartOf\":{\"@id\":\"https:\/\/hartleymedical.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg\",\"datePublished\":\"2010-12-16T23:59:53+00:00\",\"dateModified\":\"2015-06-24T04:47:21+00:00\",\"author\":{\"@id\":\"https:\/\/hartleymedical.com\/#\/schema\/person\/fca5f244d09ce1eb4e073ffb32692cef\"},\"breadcrumb\":{\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage\",\"url\":\"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall.jpg\",\"contentUrl\":\"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall.jpg\",\"width\":\"9768\",\"height\":\"1292\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/hartleymedical.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pharmacology Review: Morphine conversion to Fentanyl\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/hartleymedical.com\/#website\",\"url\":\"https:\/\/hartleymedical.com\/\",\"name\":\"Hartley Medical\",\"description\":\"21st Century Technology \/ Legendary Service\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/hartleymedical.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/hartleymedical.com\/#\/schema\/person\/fca5f244d09ce1eb4e073ffb32692cef\",\"name\":\"William Stuart\",\"sameAs\":[\"https:\/\/hartleymedical.com\/\"],\"url\":\"https:\/\/hartleymedical.com\/author\/william-stuart\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/","og_locale":"en_US","og_type":"article","og_title":"Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical","og_description":"Morphine is considered the gold standard of therapy for treatment [&hellip;]","og_url":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/","og_site_name":"Hartley Medical","article_published_time":"2010-12-16T23:59:53+00:00","article_modified_time":"2015-06-24T04:47:21+00:00","og_image":[{"url":"https:\/\/hartleymedical.com\/wordpress\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg"}],"author":"William Stuart","twitter_card":"summary_large_image","twitter_misc":{"Written by":"William Stuart","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/","url":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/","name":"Pharmacology Review: Morphine conversion to Fentanyl - Hartley Medical","isPartOf":{"@id":"https:\/\/hartleymedical.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage"},"image":{"@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage"},"thumbnailUrl":"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall-300x39.jpg","datePublished":"2010-12-16T23:59:53+00:00","dateModified":"2015-06-24T04:47:21+00:00","author":{"@id":"https:\/\/hartleymedical.com\/#\/schema\/person\/fca5f244d09ce1eb4e073ffb32692cef"},"breadcrumb":{"@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#primaryimage","url":"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall.jpg","contentUrl":"https:\/\/hartleymedical.com\/wp-content\/uploads\/2010\/12\/knowledgecenteronlysmall.jpg","width":"9768","height":"1292"},{"@type":"BreadcrumbList","@id":"https:\/\/hartleymedical.com\/pharmacology-review-morphine-conversion-to-fentanyl\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/hartleymedical.com\/"},{"@type":"ListItem","position":2,"name":"Pharmacology Review: Morphine conversion to Fentanyl"}]},{"@type":"WebSite","@id":"https:\/\/hartleymedical.com\/#website","url":"https:\/\/hartleymedical.com\/","name":"Hartley Medical","description":"21st Century Technology \/ Legendary Service","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/hartleymedical.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/hartleymedical.com\/#\/schema\/person\/fca5f244d09ce1eb4e073ffb32692cef","name":"William Stuart","sameAs":["https:\/\/hartleymedical.com\/"],"url":"https:\/\/hartleymedical.com\/author\/william-stuart\/"}]}},"_links":{"self":[{"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/posts\/362"}],"collection":[{"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/comments?post=362"}],"version-history":[{"count":0,"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/posts\/362\/revisions"}],"wp:attachment":[{"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/media?parent=362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/categories?post=362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hartleymedical.com\/wp-json\/wp\/v2\/tags?post=362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}