Morphine milligram equivalent (MME) Oral morphine: 1 MME Hydrocodone: 1 MME Oxycodone: 1.5 MME IV morphine: 3 MME
How do you calculate morphine equivalents?
- Calculate the 24 hour current dose: 90mg q 12 = 180 mg Morphine/24 hours
- Use the oral to parenteral equianalgesic ratio: 30 mg PO Morphine = 10 mg IV Morphine
- Calculate new dose using ratios: 180/30 x 10 = 60 mg IV Morphine/24 hours or 2.5 mg/hour infusion
What is the maximum morphine equivalent per day?
The rules limit opioid prescriptions to no more than a seven-day prescription for adults with acute pain. Minors may be prescribed no more than a five-day prescription with written consent by a parent or guardian. The rules also limit patients with acute pain to an average of 30 morphine equivalent dose (MMD) per day.
Is there maximum daily morphine equivalent?
Morphine is normalized to 1.0 and the conversion factor reflects the relative potency of other opioid drugs. So, if the daily MME is 90 (3) then a patient may receive no more than 90 mg of morphine, 90 mg of hydrocodone, 60 mg of oxycodone, or 30 mg of oxymorphone per day.
What is stronger morphine or oxycodone?
Oxycodone Oxycodone is 50 percent stronger than morphine. It’s prescribed and abused similarly to hydrocodone and maybe a bit more dangerous since it’s more potent. You can get oxycodone alone (OxyContin, Roxicodone) or oxycodone/acetaminophen (Percocet). Methadone Methadone is three times more potent than morphine.
What is a MED conversion calculator?
The Morphine Equivalent Dose ( MED) conversions calculator allows a clinician to generate an equivalent dose of morphine for a patient taking one or more common opioids. This tool also provides precise control over methadone conversions as well.
Is equianalgesic ratio crude?
Published equianalgesic ratios are considered crude estimates at best and therefore it is imperative that careful consideration is given to individualizing the dose of the selected opioid. Dosage titration of the new opioid should be completed slowly and with frequent monitoring.
What are the patient specific factors in the equianalgesic table?
Patient-specific factors: No equianalgesic table is able to take into account patient-specific factors — primarily hepatic function, renal function, and age. Opioid metabolism and excretion do differ among the opioids; therefore, alterations in drug disposition will alter the relative potencies of different opioids.
Why do opioids overestimate potency?
When switching between opioids, equianalgesic conversions may overestimate the potency of the new opioid due to incomplete cross-tolerance. Incomplete cross-tolerance can occur due to variability in opioid binding. There is no evidence-based recommendation for an appropriate reduction. The American Pain Society guidelines and most pain experts recommend a dose reduction between 25-50% when converting between different opioids, 9, 11 with a consideration for little or no cross-tolerance reduction in patients with poorly controlled pain. 5
Is equianalgesic table the best?
While these equianalgesic tables are current the “best” solution, their limitations should be emphasized:
Is there a lack of data regarding equianalgesic conversions?
There is an overall lack of data regarding most equianalgesic conversions, and there is a significant degree of interpatient variability. For this reason, reasonable clinical judgment, breakthrough (rescue) opioid regimens, and dose titration are of paramount importance. reasonable clinical judgment, breakthrough (rescue) opioid regimens, …