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NICE 2012
Regular oral modified release with immediate release for breakthrough (better to start with than patch)
Start at 20-30mg / day with 5mg for breakthrough
always give laxatives as well (constipation persistent SE)
nausea usually transient - if persists give antiemetic

SIGN 2008
breakthough does should be 1/6 of overall daily dose
In CKD use alfentanil, buprenorphine or fentanyl
Bone met pain - NSAID, bisphosphantes or DXT better

Inc dose when needed by 30-50% each time (guided by breakthrough amt)

Codeine or Tramadol dose to morphine - divide by 10
Oxycodone to morphine - multiply by 1.5 (?2)

Transdermal fentanyl 12 = Morphine oral 30/day
Transdermal Buprenorphine 10 = Morphine oral 24/day

Oral morphine to subcut diamorph - divide by 3
Oral oxycodone to subcut diamorph - divide by 1.5 

Note Oxycodone causes less sedation, vomiting and pruritis but more constipation cf morphine