Table 4.

Morphine Milligram Equivalent Doses for Commonly Prescribed Opioids^a

Opioidb	Conversion Factor
Codeine	0.15
Fentanyl transdermal, μg/h	2.4
Hydrocodone	1
Hydromorphone	4
Methadone, mg/d
1–20	4
21–40	8
41–60	10
≥61–80	12
Morphine	1
Oxycodone	1.5
Oxymorphone	3
Tapentadolc	0.4

^aAdapted from Von Korff M, Saunders K, Ray GT, et al. Clin J Pain. 2008;24:521–527, and Interagency Guideline on Prescribing Opioids for Pain. Washington State Agency Medical Directors’ Group. http://www.agencymeddirectors.wa.gov/Files/2015AMDGOpioidGuideline.pdf. Accessed February 19, 2016.

^bAll doses are in mg/d except for fentanyl, which is μg/h. Multiply the daily dosage for each opioid by the conversion factor to determine the dose in morphine milligram equivalents (MME). For example, tablets containing hydrocodone, 5 mg, and acetaminophen, 300 mg, taken 4 times a day would contain a total of 20 mg of hydrocodone daily, equivalent to 20 MME daily; extended-release tablets containing oxycodone, 10 mg, and taken twice a day would contain a total of 20 mg of oxycodone daily, equivalent to 30 MME daily.

^cTapentadol is a μ-receptor agonist and norepinephrine reuptake inhibitor. Morphine milligram equivalents are based on degree of μ-receptor agonist activity, but it is unknown if this drug is associated with overdose in the same dose-dependent manner as observed with medications that are solely μ-receptor agonists.