August 20, 2013
ASA Offers Recommendations to FDA on Opioid Conversion Labeling
In formal comments to the Food and Drug Administration (FDA), ASA addressed public health concerns associated with the use of equianalgesic opioid conversion tables and recommended a staged approach for opioid conversion labeling. This letter follows a July 29 FDA public workshop where ASA representative, Robert Hurley, M.D., Ph.D., a member of ASA’s Committee on Pain Medicine, testified on how to improve how opioids are converted in clinical practice.
In the letter, ASA explained that "opioid conversion recommendations must balance the risk of over-dosing with the risk of under-dosing. However, any recommendations should accept initial short-term under-treatment of pain and subsequent upward dose titration. Opioid conversion must emphasize the goal of safety by specifying the potential for dose adjustments after calculation of the equianalgesic dose." Given these principles, ASA offered a staged approach for opioid conversion labeling.
ASA will continue working with the FDA on this important issue.