How to Use the MME Calculator:
To use this calculator, input the opioid type (e.g., Buprenorphine, Codeine, Hydrocodone) and the dose (in milligrams or micrograms). The calculator will automatically calculate the Morphine Milligram Equivalent (MME), which is used to determine the strength of the opioid compared to morphine.
How to Calculate MME:
Here are the formulas to calculate MME for various opioids:
- Buprenorphine MME = 10 × Dose (mg)
- Codeine MME = 0.15 × Dose (mg)
- Fentanyl tablets (buccal/sublingual) MME = 0.13 × Dose (mcg)
- Fentanyl transdermal patch MME = 2.4 × Dose (mcg/h)
- Hydrocodone MME = 1 × Dose (mg)
- Hydromorphone MME = 4 × Dose (mg)
- Methadone MME = Conversion factor dependent on dose × Dose (mg)
- Oxycodone MME = 1.5 × Dose (mg)
- Oxymorphone MME = 3 × Dose (mg)
- Tapentadol MME = 0.4 × Dose (mg)
- Tramadol MME = 0.1 × Dose (mg)
This calculator simplifies the process of converting opioid doses to MME, helping clinicians make informed decisions about pain management.
What's a Healthy Range or Unhealthy Range?
The healthy range of MME varies based on the patient’s medical history, condition, and opioid tolerance. However, general guidelines suggest:
- Low risk: Less than 50 MME/day
- Moderate risk: 50-90 MME/day
- High risk: Above 90 MME/day
- Unhealthy range (Risk of overdose): Doses above 90 MME/day, especially if there are no safeguards such as naloxone co-prescribing or close monitoring.
Healthcare providers should adjust opioid dosing based on clinical judgment, taking into consideration patient-specific factors such as age, kidney function, history of substance use disorder, and more.
Why Use This Calculator?
- Safety: Helps prevent opioid overdose by monitoring cumulative MME.
- Consistency: Ensures standardized comparisons across various opioid medications.
- Clinical Decision-Making: Assists doctors in choosing the right opioid and dosage to manage pain safely.
What are Opioids and MME?
Opioids are powerful pain-relieving drugs, but they come with a high risk of addiction. They are typically used to treat severe, chronic pain associated with conditions like cancer or acute pain post-surgery. The Morphine Milligram Equivalent (MME) system helps compare different opioids in terms of their morphine strength.
MME uses morphine as a standard for comparison, converting the dosage of other opioids to their equivalent in morphine. For example, 1 mg of hydrocodone is equivalent to 1 mg of morphine in pain-relieving strength, while 1 mg of oxycodone is equivalent to 1.5 mg of morphine.
Opioid Dosing Rules:
- Start with non-opioid drugs (e.g., paracetamol or ibuprofen) whenever possible.
- Use the lowest effective dose of opioids.
- Decrease the dose or discontinue opioids as soon as pain management allows.
- Use co-analgesia (additional pain relief drugs) when appropriate.
- Trust clinical judgment since individual patient responses to opioids can vary.