A 72-year-old male with metastatic prostate cancer to the bone is being transitioned from oral morphine SR 60 mg every 12 hours to a continuous subcutaneous infusion of hydromorphone due to dysphagia.
His pain is currently well-controlled.
Using a standard equianalgesic table (e.g., 30mg oral morphine = 10mg parenteral morphine; 10mg parenteral morphine = 1.5mg parenteral hydromorphone), what is the most appropriate starting dose for the hydromorphone infusion over 24 hours?
