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Frequently Asked Questions

How is the daily morphine equivalent dose calculated?

Instructions: Fill in the mg per day for the patient’s opioid medications. The daily morphine equivalent dose is calculated automatically. Methadone has been associated with disproportionate numbers of overdose deaths relative to the frequency with which it is prescribed for chronic pain, due in part to its long and variable half-life.

Can morphine be used as a reference point for conversion to Mme?

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.

What is the conversion factor of morphine to fentanyl?

Assumption two 3,11: morphine (oral) 2 mg = transdermal fentanyl 1 mcg/hour. 'Breitbart method' morphine (oral) 50mg = transdermal fentanyl 25 mcg/hour. (x /30) * 50 = 0.6 or 50x = 18 --> x = 0.36 (conversion factor) Conversion from these dosage forms are 1:1 but require special handling.

How do you calculate equivalent daily dose of an opioid?

Determine equivalent daily dose of new opioid by dividing the calculated MMEs of current opioid by new opioid’s conversion factor. Reduce this amount by 25-50% and then divide into appropriate intervals. The dose conversions listed above are an estimateand cannot account for an individual patient’s genetics and pharmacokinetics.

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