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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Morphine Milligram Equivalents (MME) Calculator

    Calculates total daily morphine milligram equivalents.

    IMPORTANT

    There is no completely safe opioid dose, and this calculator does not substitute for clinical judgment. Use caution when prescribing opioids at any dosage, and prescribe the lowest effective dose.

    Conversions are based on the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.

    INSTRUCTIONS

    Note: This is for converting oral opioids only, and should not be used for IV to oral conversions. 

    For combination drugs (e.g. Percocet = acetaminophen + oxyCODONE), enter only the dose of the opioid component (e.g. if 5 mg/325 mg, enter "5"). Do not use in pediatric patients, due to unpredictable rates of absorption and risk of overdose.

    As a partial opioid agonist, buprenorphine is not expected to be associated with overdose risk in the same dose-dependent manner as doses for full agonist opioids and is therefore omitted from the calculator.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Use in opioid-naïve and opioid tolerant adult patients.
    • Do not use in pediatric patients, due to unpredictable rates of absorption and risk of overdose.
    • Do not use in patients with malignant pain or those requiring end-of-life care.
    • Uses morphine as the reference point for conversion of other oral opioids to MME.
    • Should be used only for oral opioid conversion to MME, not for conversion of one opioid to another.
    • Equianalgesic dose ratios are approximations and do not account for genetic factors, incomplete cross-tolerance, and pharmacokinetics.
    • Does not give information on efficacy, but is used to assess comparative potency of other analgesics.
    • Pharmacokinetics and conversion for methadone and tapentadol are particularly complex, and clinicians should err on the side of being especially conservative with those conversions in particular.
    • MME is a numerical standard against which most opioids can be compared, yielding a comparison of each medication’s potency.
    • Helps determine whether a cumulative daily dose of opioids is associated with increased risk of overdose.
    • Helps identify patients who may benefit from closer monitoring, reduction or tapering of opioids, naloxone prescription, and other measures to reduce risk of potential opioid abuse and/or overdose.
    Choose one
    mg/dose
    doses/day
    No
    Yes

    Result:

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    Next Steps
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    OTHER

    About the Creator

    Other creator.

    Content Contributors
    • Sergey Motov, MD
    About the Creator
    OTHER
    Content Contributors
    • Sergey Motov, MD