When titrating opioid doses, what must be considered when switching from intravenous to oral dosing?

When transitioning from intravenous to oral opioid dosing, it is essential to consider the relative potency of the different routes of administration. Opioids given intravenously typically bypass first-pass metabolism and provide a more immediate effect at a given dose, making them more potent compared to oral formulations.

In the case of oral hydromorphone, it is indeed less potent when compared to its intravenous counterpart. Specifically, when switching to oral dosing, the dose needs to be adjusted to account for this difference in potency. This reflects the pharmacokinetics of the drug, where oral opioids may require higher doses to achieve similar analgesic effects as their intravenous forms.

Taking this into consideration helps to avoid underdosing when making the switch. Thus, understanding that oral hydromorphone is less potent than intravenous hydromorphone is crucial for safely and effectively managing pain during the transition between routes of administration.