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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.
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.
14 sie 2023 · IV: 0.1 mg to 0.2 mg/kg via slow IV injection every 4 hours as needed to manage pain; alternatively, 2 to 10 mg IV (based on 70 kg adult) IM: 10 mg IM every 4 hours as needed to manage pain (based on 70 kg adult)
1mg – 2mg (1,3,4) Potency if switching from hydromorphone to morphine is less than from morphine to hydromorphone
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.
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.
