What Does Milligram Morphine Equivalents (MME) Mean?
Morphine milligram equivalents (MME), or morphine equivalent doses (MED), is a value used to compare the potency of an opioid dose relative to morphine.
MME is determined by multiplying the dose of a prescribed opioid by the number of times it is taken in a day. That total is then multiplied by a conversion factor for that specific opioid relative to morphine. For example:
- Codeine 30 mg × 4 times a day = 120 × 0.15 (conversion for codeine) = 18 MME
- Oxycodone 5 mg × 4 times a day = 20 × 1.5 (conversion for oxycodone) = 30 MME
- Hydromorphone 4 mg × 4 times a day = 16 × 4 (conversion for hydromorphone) = 64 MME.
To figure out the total MME if an individual is taking more than one opioid, calculate the MME for each medication and then add the MMEs together. A list of conversion factors can be found at Utah Department of Health, Medicaid. There are also opioid calculators that can help, such as Practical Pain Management’s opioid calculator.
Opioid doses equivalent to 1 mg of morphine
Note: Conversions that do not equate exactly to 1 mg of morphine are noted in parentheses. Conversions were made with the Oregon Pain Guidance opioid conversion calculator.
- Codeine – 7 mg (1.05 morphine)
- Fentanyl transdermal – 0.4 mcg/hr (0.96 morphine)
- Hydrocodone – 1 mg
- Hydromorphone – 0.25 mg
- Oxycodone – 0.65 mg (0.975 morphine)
- Oxymorphone – 0.35 mg (1.05 morphine)
- Tramadol – 10 mg
- Tapentadol – 2.5 mg