A metric of opioid use in chronic pain management is the MME (milligram morphine equivalent per day). This is an abbreviated listing of narcotic equivalent dosing.
Short-acting opioids are typically given orally every 4 hours (q4h).
Opioid
MME Factor
morphine in mg
1
tapentadol in mg
0.4
hydrocodone in mg
1
butorphanol in mg
1
oxycodone
1.5
heroin
2.5
oxymorphone
3 to 4 (use 3.5)
hydromorphone
4 to 5 (use 5)
fentanyl patch in µg/hr
2
methadone
4 to 20 (use 4)
codeine (Tylenol #3, #4)
0.1667
MME for each drug =
= (daily dose of drug in mg) * (MME factor)
total MME per day =
= SUM(MME for each drug)
Interpretation:
• A total MME per day above certain thresholds may be an indication of inappropriate opioid use.
• The total daily MME can be used when converting from a short to longer acting opioid.
To read more or access our algorithms and calculators, please log in or register.
