💊 Opioid Equianalgesic Converter (OME)
Convert daily opioid doses between agents using oral morphine equivalents (OME/MME), with a built-in incomplete cross-tolerance reduction range. Free, instant, browser-side.
Opioid Equianalgesic Converter (OME)
Current drug · route
Current total dose (mg/day)
Target drug · route
When to use
Opioid rotation and OME calculation for chronic pain and palliative care. Excludes methadone, fentanyl and buprenorphine, which convert non-linearly and need specialist handling.
How it works
OME = current dose × conversion factor (oral morphine = 1, IV morphine ≈ 3, oral oxycodone ≈ 1.5, oral hydromorphone ≈ 4). Target unreduced dose = OME ÷ target factor; suggested start reduces 25–50% for cross-tolerance.
Key points
- Always reduce 25–50% when rotating; take the larger reduction at high doses, in the elderly or with sedatives.
- OME ≥ 50 mg/day warrants caution; ≥ 90 mg/day is high-risk for overdose.
- Provide rescue analgesia and monitor for respiratory depression and sedation.
- Equivalences vary by source and are estimates — verify against your formulary.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.