Equivalent Dose & Drug Conversions / Transfers / Switching

Proton Pump Inhibitor (PPI) Agents and Defined Daily Dose Equivalents

Table 2: PPI Agents and Defined Daily Dose Equivalents

• Source: ncbi.nlm.nih.gov
• Clinical Resource: Journal Article
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Interchangeable Use of Proton Pump Inhibitors Based on Relative Potency

We conclude that PPIs can be used interchangeably based on potency. Using twice-daily PPIs is more effective in increasing efficacy increasing once-daily PPI dosage. Omeprazole and lansoprazole (30 mg) and 20 mg of esomeprazole rabeprazole are functionally equivalent.

• Source: cghjournal.org
• Clinical Resource: Journal Article
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Comparison of Angiotensin Converting Enzyme (ACE) Inhibitors – Vancouver Acute Pharmaceutical Sciences

• Source: vhpharmsci.com
• Clinical Resource: Table
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Comparison of Angiotensin II Receptor Blockers (ARBs) – Vancouver Acute Pharmaceutical Sciences

• Source: vhpharmsci.com
• Clinical Resource: Table
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Angiotensin II Receptor Blockers (ARBs) Comparable Dose Chart

To help clinicians with selecting an alternative ARB, we wanted to share the following table of comparable doses

• Source: blogs.pharmacy.umaryland.edu
• Clinical Resource: Article
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Properties of Beta-Blockers – Vancouver Acute Pharmaceutical Sciences

• Source: vhpharmsci.com
• Clinical Resource: Table
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Appendix B Beta-Blockers (BB) > Page 2 – Beta-Blocker Equivalent Doses

• Source: gov.bc.ca
• Clinical Resource: Table
• Register to Access Content: No

Switching doxazosin XL tablets to doxazosin standard release tablets

Doxazosin XL tablets should not routinely be prescribed. Guidance is provided on switching doxazosin XL tablets to standard release tablets.

• Source: sps.nhs.uk
• Clinical Resource: Guidance
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Dosage Equivalence of HMG CoA Reductase Inhibitors (“Statins”) – Vancouver Acute Pharmaceutical Sciences

• Source: vhpharmsci.com
• Clinical Resource: Table
• Register to Access Content: No

Grouping of statins
Cardiovascular disease: risk assessment and reduction, including lipid modification NICE Guidelines

Statins are grouped into 3 different intensity categories according to the percentage reduction in low-density lipoprotein cholesterol:

a 20% to 30% reduction is low intensity
a 31% to 40% reduction is medium intensity
a reduction of more than 40% is high intensity.

• Source: nice.org.uk
• Clinical Resource: Guidelines
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Switching between aminophylline and theophylline in adult respiratory care

Intravenous aminophylline is used acutely for emergency respiratory conditions and we give a stepped approach on how to switch to oral theophylline

• Source: sps.nhs.uk
• Clinical Resource: Guidance
• Register to Access Content: No

Tiotropium dose equivalence and conversion of different brands

Source: References 1-2

Approximate equivalent doses of oral corticosteroids

The equivalent doses are based on the anti-inflammatory potency.

Neither the mineralocorticoid effects nor the differences in the duration of action of the corticosteroids are considered in the table.

Source: Reference 3

Corticosteroid Conversion Table

• Source: med.umkc.edu
• Clinical Resource: Table
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Corticosteroid Equivalent Dose Calculator

sterconv.html is a Javascript application which converts milligrams of various corticosteroids to the equivalent dose of Methylprednisolone. The conversion data is adapted from Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 9th ed.

• Source: hedwig.mgh.harvard.edu
• Clinical Resource: Calculator
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Corticosteroid Equivalent Dose Calculator

Corticosteroid Converter – based on anti-inflammatory potency

• Source: globalrph.com
• Clinical Resource: Calculator
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What is the equivalent dose of oral prednisolone to intravenous (IV) hydrocortisone?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

From the literature, prednisolone 5mg is approximately equivalent to hydrocortisone 20mg in terms of equivalent anti-inflammatory dose.

• Source: sps.nhs.uk
• Clinical Resource: Medicines Question and Answer
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Potency of Topical Corticosteroids (USA Classification)

Topical corticosteroids potency chart for USA

• Source: knowledgedose.com
• Clinical Resource: Chart

Potency of Topical Corticosteroids (UK Classification)

Topical corticosteroids potency chart for UK

• Source: knowledgedose.com
• Clinical Resource: Chart

Relative Potency of Selected Topical Corticosteroids

Topical corticosteroids range in potency from mild (class VII) to superpotent (class I— Relative Potency of Selected Topical Corticosteroids). Intrinsic differences in potency are attributable to fluorination or chlorination (halogenation) of the compound.

• Source: msdmanuals.com
• Clinical Resource: Table
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Dose Equivalents and Changing Opioids

Considerations when switching opioids

• Source: fpm.ac.uk
• Clinical Resource: Tables
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Opioid Conversion Ratios
Eastern Metropolitan Region Palliative Care Consortium

Opioid conversion is a specialist skill used by palliative care clinicians to ensure appropriate use of palliative medicines and that the patient receives optimal pain management. This document is intended for use by specialist palliative care clinicians. It also serves as an educational and clinical support resource for specialist clinicians when they are training other healthcare professionals who may be part of the extended multidisciplinary care team.

• Source: emrpcc.org.au
• Clinical Resource: Guideline
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Opioids and Methadone Equivalents for Clinicians

We provide an opioid conversion table for commonly used opioid preparations to help clinicians better understand the relationship between these agents and methadone. Conversion must take into consideration clinical issues that affect translation of equivalents to and from methadone.

• Source: nih.gov
• Clinical Resource: Journal Article
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A Guide to Equivalent Doses for Opioid Drugs

• Source: rowcrofthospice.org.uk
• Clinical Resource: Guide
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Choosing and Changing Opioids

• Source: palliativecareguidelines.scot.nhs.uk
• Clinical Resource: Guidelines
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Opioid Conversion Chart

The dosage of a new opioid is based on several factors including the available equi-analgesic dose data, the clinical condition of the patient, concurrent medications and patient safety. It is recommended that the new dose should be reduced by 30-50% to allow for incomplete cross-tolerance. The patient should be monitored closely until stable when switching opioid medications.

• Source: olh.ie
• Clinical Resource: Chart
• Register to Access Content: No

Opioid dose conversion chart, syringe driver doses, rescue/PRN doses and opioid patches

Use the conversion chart to work out the equivalent doses of different opioid drugs by different routes

• Source: yorkhospitals.nhs.uk
• Clinical Resource: Chart
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Switching between oral morphine and other oral opioids in adult palliative cancer care patients

Switching between morphine and alternative opioids requires care and thoughtful application of a stepped process

• Source: sps.nhs.uk
• Clinical Resource: Guidance
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Conversion of Gabapentin to Pregabalin: Simple & easy

Dose equivalencies of Gabapentin & Pregabalin for the conversion protocol

• Source: apsoc.org.au
• Clinical Resource: Newsletter
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Gabapentinoids: when and how should they be prescribed?

How to switch between gabapentinoids or stop

• Source: bpac.org.nz
• Clinical Resource: Article
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Parkinson’s Disease ‘Nil by Mouth’ Medication Dose Calculator

In patients unable to take their usual PD medications orally, this tool is designed to convert a patient’s usual PD medications to a ‘Levodopa equivalent dose’ (LED).

The LED can then be used to calculate what dose of dispersible madopar should be given via a nasogastric tube to provide a patient with their usual amount of PD medication.

The tool also provides a conversion to a rotigotine patch dose.

• Source: pdmedcalc.co.uk
• Clinical Resource: Calculator
• Register to Access Content: No

Switching Antidepressants

The goal of this switching table is to offer a guide for physician and pharmacist in switching antidepressants. The table should be clear, easy to use and contains the most important information. Therefore, the table only contains the most commonly used antidepressants.

• Source: wiki.psychiatrienet.nl
• Clinical Resource: Table
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Conversion from citalopram tablets to citalopram drops or vice versa

Citalopram tablet to oral drops conversion

Source: Reference 4

Switching Antipsychotics

The goal of this switching table is to offer a guide for physician and pharmacist in switching antipsychotics. The table should be clear, easy to use and contain the most important information. Therefore, the table only contains the most common or special antipsychotics. There is also a group ‘rest AP’, containing antipsychotics with the same switching advice.

• Source: wiki.psychiatrienet.nl
• Clinical Resource: Table
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Antipsychotic switching tool

This tool aims to assist prescribers when changing a patient’s antipsychotic treatment.

• Source: nps.org.au
• Clinical Resource: Tool
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Haloperidol IM and oral equivalent doses

• Source: hpft.nhs.uk
• Clinical Resource: Table
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Equivalent doses of oral benzodiazepines

Benzodiazepine equivalent chart

Source: References 5-6

The Benzodiazepines > Potency

A large number of benzodiazepines are available. There are major differences in potency between different benzodiazepines, so that equivalent doses vary as much as 20-fold.

• Source: benzo.org.uk
• Clinical Resource: Manual
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Benzodiazepines Equivalents

• Source: sahealth.sa.gov.au
• Clinical Resource: Conversion Chart
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HRT preparations and equivalent alternatives

The British Menopause Society (BMS) has produced this document to provide guidance to
BMS members and clinical practitioners to provide information regarding equivalent HRT
preparations.

• Source: thebms.org.uk
• Clinical Resource: Document
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Australasian Menopause Society Guide to Equivalent MHT/HRT Doses Australia only

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different TGA registered MHT/HRT products available in Australia in May 2020. HRT is now referred to as Menopausal Hormone Therapy (MHT).

Australasian Menopause Society Guide to Equivalent MHT/HRT Doses New Zealand only

This Information Sheet has been developed as a guideline only to approximately equivalent doses of the different MHT/HRT products available in New Zealand in October 2019. HRT is now referred to as Menopausal Hormone Therapy (MHT).

• Source: menopause.org.au
• Clinical Resource: Information Sheets
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Sulfonylurea Equivalent Doses / Switching Advice

Switching between gliclazide MR and gliclazide standard release
Sulfonylurea equivalent dose chart

• Source: knowledgedose.com
• Clinical Resource: Summary

Equivalent doses of Carbimazole and Propylthiouracil

Converting carbimazole to propylthiouracil or vice versa

Source: Reference 7

Switching between neostigmine and pyridostigmine in myasthenia gravis

In some cases, the prescriber may wish to switch between oral pyridostigmine and parenteral neostigmine e.g. due to swallowing difficulties caused by worsening of myasthenia gravis. As symptoms of myasthenia gravis improve, a switch to an oral formulation may be preferred.

• Source: sps.nhs.uk
• Clinical Resource: Guidance
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Intravenous-to-Oral Switch Therapy

Switching from intravenous (IV) to oral (PO) therapy as soon as patients are clinically stable can reduce the length of hospitalization and lower associated costs. While intravenous medications may be more bioavailable and have greater effects, some oral drugs produce serum levels comparable to those of the parenteral form. Medications involved in switch therapy include antibiotics, analgesics, antipsychotics, and antivirals.

• Source: medscape.com
• Clinical Resource: Article
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