Morphine Milligram Equivalents (MME) Calculator
Converts opioid doses to morphine milligram equivalents (MME) to assess total opioid burden, guide dose adjustments, and identify high-risk prescribing. Daily MME ≥ 90 mg/day associated with overdose risk (adults). Children: use a children's formulary.
Score interpretation
Daily MME < 50 (adults): Low opioid burden. Children: use a children's formulary.
→ Standard prescribing. Review pain control adequacy. Ensure bowel regimen co-prescribed. Reassess at each review.
Daily MME 50–89 (adults): Moderate opioid burden. Children: use a children's formulary.
→ Review indication and efficacy. Consider specialist pain review. Ensure naloxone co-prescribed if high-risk patient. Assess for dependence and side effects.
Daily MME ≥ 90 (adults): High opioid burden. 3-fold increased overdose risk vs < 20 MME/day (CDC). Children: use a children's formulary.
→ Urgent specialist pain / palliative care review. Co-prescribe naloxone, patient-held (adults: 400µg SC/IM). Children: use a children's formulary. Consider opioid rotation. Avoid concurrent benzodiazepines. Taper if appropriate. Document risk discussion.
Interpretation bands for the MME Calculator. Apply clinical judgement and local guidance.
References
- Dowell D, et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95.
Related
Curated clinical cross-links plus same-class fallbacks.
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Morphine (Orthopaedic Acute Pain) · Opioid Analgesic — Strong
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Morphine PCA (Burns Pain) · Opioid Analgesic (Patient-Controlled Analgesia)
- Morphine (PCA — Post-Operative Pain) · Opioid Analgesic — Patient-Controlled Analgesia
- Morphine · Opioid Analgesic — Severe Ureteric Colic / Post-Operative Pain
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.