MME Calculator

Milligrams for oral forms; micrograms per hour for a transdermal patch; micrograms for buccal, film and nasal fentanyl.
Ignored for transdermal patches, whose factor is already expressed per day of wear.
Milligrams for oral forms; micrograms per hour for a transdermal patch; micrograms for buccal, film and nasal fentanyl.
Ignored for transdermal patches, whose factor is already expressed per day of wear.
Milligrams for oral forms; micrograms per hour for a transdermal patch; micrograms for buccal, film and nasal fentanyl.
Ignored for transdermal patches, whose factor is already expressed per day of wear.
Milligrams for oral forms; micrograms per hour for a transdermal patch; micrograms for buccal, film and nasal fentanyl.
Ignored for transdermal patches, whose factor is already expressed per day of wear.
The standard safety haircut when rotating opioids is 25-50%, larger when the current dose is high.
Total MME per day
60.00 MME/day
Opioid MME (Morphine Milligram Equivalent) Calculator
CDC review threshold
60 MME/day is at or above 50 - CDC advises carefully evaluating the benefits and risks of increasing further
MME after cross-tolerance reduction
45.00 MME/day
Factor set used
CDC 2022 Clinical Practice Guideline
Worked out from CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022 (MMWR Recomm Rep 2022;71(RR-3)) and 3 other sources.
The 2022 CDC guideline advises carefully evaluating benefits and risks when increasing to >= 50 MME/day and avoiding or carefully justifying a decision to titrate to >= 90 MME/day. These are prompts for review, not hard limits, and the guideline explicitly warns against applying them as inflexible policy.
For clinical use by a qualified prescriber only, and subject to specialist review before release. CDC states these factors are for analysing prescription data, not for converting a patient from one opioid to another; they do not account for incomplete cross-tolerance, individual pharmacogenetics, renal or hepatic impairment. Methadone and transdermal fentanyl are especially hazardous to convert and buprenorphine factors were withdrawn by CDC in 2017. Never start a new opioid at the calculated equivalent dose without an independent reduction and close monitoring.

How this is worked out

3 steps
  1. Oxycodone: 40 mg/day x 1.5 = 60 MME/day
  2. Total = 60 MME/day
  3. 60 MME/day is at or above 50 - CDC advises carefully evaluating the benefits and risks of increasing further
Per-drug workingtable
Oxycodone: 10 mg x 4/day = 40 mg/day x 1.5 = 60 MME/day (CDC 2022 Clinical Practice Guideline factor 1.5)

Results are general information, not financial, tax, legal, medical or engineering advice.