Add medication
Enter one med at a time. Repeat for every opioid the patient is on; they all add up below.
Or paste a medication administration record (MAR)
Medications
No medications yet. Add one above.
Patient context optional, tailors safety alerts
All fields default to "not specified" and never affect MME math, only which safety alerts fire.
Medications
No medications yet. Add one above, or paste an MAR.
Convert to a target opioid
Conversion factors & assumptions
MME factors (per mg unless noted). Derived from the GlobalRPh equianalgesic table (oral morphine = 30 mg chronic baseline) and CDC tiered methadone factors.
| Drug | Route | MME / mg |
|---|---|---|
| Morphine | PO | 1 |
| Morphine | IV / IM / SC | 3 |
| Hydromorphone | PO | 4 |
| Hydromorphone | IV / IM / SC | 20 |
| Oxycodone | PO | 1.5 |
| Oxymorphone | PO | 3 |
| Oxymorphone | IV / IM / SC | 30 |
| Hydrocodone | PO | 1 |
| Codeine | PO | 0.15 |
| Codeine | IV / IM / SC | 0.25 |
| Tramadol | PO | 0.1 |
| Tapentadol | PO | 0.4 |
| Meperidine | PO | 0.1 |
| Meperidine | IV / IM / SC | 0.4 |
| Fentanyl | IV / IM (per mcg) | 0.3 |
| Fentanyl | Transdermal (per mcg/hr) | 2.4 / day |
| Methadone PO | 1–20 mg/day | 4 |
| Methadone PO | 21–40 mg/day | 8 |
| Methadone PO | 41–60 mg/day | 10 |
| Methadone PO | >60 mg/day | 12 |
Caveats. Published equianalgesic ratios are estimates. Methadone conversions in opioid-tolerant patients should involve a pain or palliative specialist. Account for residual fentanyl release for 12–36 hours after patch removal and for any long-acting formulations. Use extra caution in elderly patients and in hepatic, renal, or pulmonary disease. This tool is not a substitute for clinical judgement.
Dose timeline
Each line is one dose's pharmacokinetic curve, scaled to its MME contribution. Parsed MAR entries use their real administration times; manually-added meds are plotted at evenly-spaced implied times across the window.
Doses on file
About this calculator
A bedside tool for converting any opioid regimen (scheduled, PRN, PCA, transdermal) into a single daily morphine milligram equivalent (MME), with conversion to a target opioid and CDC-aligned risk flags.
How it works
- Add medications. Use Simple for a quick one-off conversion or Complex to paste an MAR, add PCA settings, and choose a 24/48/72-hour window. Each entry is stored as drug + route + dose; the math is re-derived on every change.
- Per-medication MME. Daily dose is multiplied by the route-specific factor from the active equianalgesic table (CDC 2022, GlobalRPh, or ASCO; switch in Settings). Fentanyl IV uses mcg → MME directly; transdermal fentanyl uses mcg/hr × 24 × factor.
- Methadone is tiered. The factor depends on the patient's total daily methadone dose, per the selected table. The chosen tier and the daily dose that triggered it are shown in the derivation panel for that row.
- Total & risk. Per-med MME values are summed into the daily total and compared against CDC thresholds: under 50, 50–89 (caution), and ≥90 mg/day (high risk). Patient context (age, renal, hepatic) only changes which safety alerts fire, never the math.
- Convert & export. Pick a target opioid and a cross-tolerance reduction (0–50%) to see the suggested replacement dose. Use Copy as note for a plaintext summary, Copy shareable URL for a link that re-creates the regimen, or Print for a clean clinical handout.
What it isn't
Equianalgesic ratios are population estimates, not prescriptions. Methadone rotations and opioid-tolerant conversions warrant a pain or palliative consult. Account for residual fentanyl release for 12–36 hours after patch removal and for the kinetics of any long-acting formulation. This is decision support, not a substitute for clinical judgement.
Privacy
Fully client-side. No medication data leaves your device. Optional persistence uses this browser's local storage only. Shareable URLs encode the regimen in the link's hash fragment, which browsers never send to a server.
Source & theming
Open source at github.com/robbie-med/Mme. If you'd like to integrate this into a hospital intranet or institutional site with your own colors, logo, and footer disclaimer, get in touch at [email protected].
S.D.G.
Settings
Determines every MME calculation, the methadone tier breakpoints, and the citation shown in derivations. CDC is the US default for prescribing-guideline MME thresholds.
When on, your medication list is saved to this device's local storage and restored when you reopen the app. Nothing is sent anywhere.
Install this app to your home screen / dock for one-tap offline access.
Checking…
All data stays on your device. The app is fully client-side.