Morphine, and derivatives, remain the cornerstone of cancer pain management. They share the same clinical spectrum but exhibit different pharmacological profiles. Some derivatives have specificity regarding pain control (i.e. neuropathic pain) potency or toxicity. The interest of having different opioids relies in part on inter-individual genetic variability (in terms of metabolism or receptor affinity). The specificity of breakthrough pain syndrome is considered. Because of various available converting ratio, a simplified converting table is proposed.
(BELG J MED ONCOL 2014;8(1):9–13)