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Calculates total daily morphine milligram equivalents. 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.
Consider the need to adjust dose for conditions that increase opiate risk (eg elderly, co-morbidities, renal or hepatic impairment). Where dose equivalence is expressed as a range, use the value that produces the lowest equivalent dose and titrate as necessary. Particular care is required when dealing with high doses of opiates.
14 sie 2023 · Between 3 and 6 mg of oral morphine provides pain relief equivalent to 1 mg of parenteral morphine PATIENT CONTROLLED ANALGESIA (PCA): For use in a compatible infusion device; patient must be closely monitored because of the considerable variability in both dose requirements and patient response.
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.
For example, if your reduced IV morphine dose was 50mg, the equivalent IV hydromorphone dose is 10mg. Divide this number by the bioavailability of the new drug to get a bigger number, that being the oral 24 hour dose of the new drug.
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.
When morphine at lower doses (e.g., 30–60 mg/d orally) is switched to methadone, the potency may be 3 to 5 times; when switched from high doses (e.g., >300 mg/d orally), the potency may be 12 times or even higher. h Caution: The oral to IV dose ratio of methadone is not well established.
