Opioid Potency Comparison

Medical Editor: Benjamin C. Wedro, MD, FAAEM
Narcotic medications vary in their potency. Each drug has a different prescription range of effectiveness and the number of milligrams in the dosage is not an indiucation of how strong the emdication might be.For example, the dose of hydormorphone (dialudid) needs to be only 1.5 mg to equal the effectiveness of 10mg of morphine.
In general medications given intravenously or by intramuscular injection will have a quicker onset of action than medications given orally.

Medication	Route	Time to Effect	Duration	Routine Dosage Equivalent
Morphine Sulphate	IV IM PO	5-10 min 15-30 min 30-60 min	3-6 hours 3-6 hours 3-6 hours	10 mg IV 10 mg IM 30-60 mg PO
Oxycodone	PO	10-15 min	4-6 hours	10-20 mg PO
Hydrocodone	PO	30-60 min	4-6 hours	15-30 mg PO
Fentanyl	IV	Immediate	1-2 hours	50 micrograms IV
Hydromorphone	PO IV IM	15-30 min 15 min 15 min	4-6 hours 4-6 hours 4-6 hours	7.5 mg 1.5 mg 1.5 mg
Codeine	PO	30-60 min	4-6 hours	200 mg
Nalbuphine	IM	15 min	3-6 hours	10 mg

IV = intravenous
IM = intramuscular
PO = orally

Routine dosage equivalent to Morphine 10 mg IM or IV