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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.
The FDA defines an opioid-tolerant patient as receiving for 1 week or longer at least 60 mg oral morphine/day or an equianalgesic dose of another opioid. OME calculations facilitate monitoring changes in opioid utilization over time.
As the total daily chronic dose of morphine increases, the equianalgesic dose ratio (morphine:methadone) changes (American Pain Society 2016). Total daily dose should be divided by 3; delivered every 8 hours.
Table 1: Pharmacokinetic Data for Oral Opioids . Starting Dose Onset Peak Duration Half life Codeine 30 - 60 mg q 4 hr 30 min 1.5 hr 6 hours 2-4 hr Morphine SA 10 - 15 mg q 3 - 4 hr 15 min 1.5-2 hr 4 hr 1.5-2 hr Hydrocodone 5-10 mg q 4-6 hr 60 min 2 hr 4-6 hr 4 hr Oxycodone 5-10 mg q 4-6 hr 15-30 min 1-2 hr 4-6 hr 4 hr
For example, if the bioavailable codeine dose is 100 mg, the IV morphine equivalent is 10mg. If any opioids are being given parenterally, add them to the list at this point, and convert them to IV morphine equivalents as well.
14 sie 2023 · Initial dose: 5 mg in the lumbar region may provide satisfactory pain relief for up to 24 hours. If adequate pain relief is not achieved within 1-hour, doses of 1 to 2 mg may be given at intervals sufficient to assess effectiveness. Maximum dose: 10 mg per 24 hours.
Equianalgesic Doses of Opioid Analgesics*,†. † See also Kreutzwiser D, Tawfic QA and Pain Guidelines (based on Quill TE: Primer of Palliative Care, ed. 7. Chicago, Academy of Hospice and Palliative Medicine, 2019). OMME = oral morphine milligram equivalents.
