NICU IV fentaNYL to PO morphine Calculator – IWK Drug Information Resource

Note: This calculator is intended for patients receiving IV fentaNYL for greater than 10 days and provides only a rough estimate for converting IV fentaNYL to PO morphine. There is significant individual response to various opioids as well as unpredictable or incomplete tolerance between opioids; clinical judgement must always be used when converting opioids. Neonates can be more susceptible to adverse effects of opioids therefore consider starting at a lower dose than what the conversion suggests.

Current Rate of IV fentaNYL *

micrograms/kg/hour

Dosing Frequency for PO morphine *

Patient Weight (Use Weight on Pump) *

Reset

Please note: the calculated PO morphine dosing is an approximate conversion; consider a decrease or increase in recommended dose depending on the patient’s clinical status.

Consider the following prior to implementation:

Does the dose calculated make sense? How does it compare to the Neonatal and/or Pediatric morphine drug dosing guideline?
If concerned about treating pain in addition to withdrawal, a higher dose may be needed. If withdrawal is the only concern, consider starting at a lower dose.
Consider ordering a PO morphine breakthrough dose (one half of the calculated maintenance dose)