The four opioids on this site, side by side, as their own monographs state them. IV figures shown; the fentanyl, meperidine and morphine monographs also give IM and oral timings. Naloxone (Narcan) is the reversal agent for all four.
| Agent | Route | Onset | Peak | Duration | Adult dose (as stated) | Reversal |
|---|---|---|---|---|---|---|
| Fentanyl (Sublimaze) | IV (also IM, transmucosal) | 1–2 minutes | 5–15 minutes | 30–60 minutes | 25–100 mcg slow IV over 1–2 minutes, titrated 25 mcg at a time; 200 mcg total for nursing administration in a healthy young adult | Naloxone (Narcan) |
| Morphine Sulfate | IV (also IM, oral) | 5–10 minutes | 20 minutes | 4–5 hours | 0.03–0.1 mg/kg in 1 mg increments IV, given slowly; total 10 mg in 60 minutes | Naloxone (Narcan) |
| Meperidine (Demerol) | IV (also IM, oral) | 1 minute | 5–7 minutes | 2–4 hours | 25 mg slow IV push, titrated in 25 mg increments; total 100 mg in 60 minutes; contraindicated with MAO inhibitors | Naloxone (Narcan) |
| Hydromorphone (Dilaudid) | IV, IM, SC, oral | Parenteral: about 15 minutes; oral: within 30 minutes | — | Parenteral: more than 5 hours | IV, opiate-naive: 0.2–0.6 mg every 2–3 hours as needed, given very slowly (2 mg in 9 mL saline = 0.2 mg/mL) | Naloxone (Narcan) |
Every figure above is taken from the linked monograph on this site; a dash means the monograph does not state it. Verify all doses against the current package insert and your facility protocols before clinical use.
DILAUDID® Hydromorphone HCl
Meperidine (Demerol)
Fentanyl (Sublimaze)
Morphine Sulfate
Reversal:
Naloxone (Narcan)
Educational reference for sedation providers, relocated from the previous version of this site — not a substitute for the current package insert, your facility protocols, or clinical judgment. Verify all doses against current references before clinical use.