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500 – 999 mg 15 : 1 6.6% > 1,000 mg 20 : 1 5% Example of conversion to oral methadone: 1. ®Patient is taking 80 mg OxyContin orally 3 times daily. 2. The total daily dose of oxycodone is 240 mg daily. 3. The next step is to convert 240 mg of oral oxycodone to the daily oral morphine equivalent dose (DOMED). 4.
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.
Step 1: Calculate current total daily usage of opioids. Morphine 30 mg /dose x 6 doses/day = 180mg/day. Step 2: Calculate the equipotent dose (consult conversion table).
180. < 30 OMME/day: 2:1. 31–99 OMME/day: 4:1. 100–299 OMME/day: 8:1. 300–499 OMME/day: 12:1. 500–999 OMME/day: 15:1. ≥ 1000 OMME/day: 20:1. † 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).
Opioid Conversion Tables . Ernest Dole , Pharm.D., BCPS , PhC, FASHP . Clinical Pharmacist , University of New Mexico Hospitals . Chronic Pain C onsultation ...
Oral Morphine Equivalents (OME) are approximations of the equianalgesic effects of other opioids compared to oral morphine. Thus, OMEs indicate how much of the reference drug oral morphine would be required to treat pain as effectively as the opioid morphine is compared with.
The equianalgesic chart indicates that 1.5 mg of parenteral hydromorphone equals 7.5 mg of oral hydromorphone (a 5-fold increase). The patient’s current dose of 5 mg per day of parenteral hydromorphone is equal to 25 mg per day of oral hydromorphone.
