💊 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.
Always reduce 25–50% when rotating; take the larger reduction at high doses, in the elderly or with sedatives.
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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
Frequently asked questions
- What is 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.
- How is Opioid Equianalgesic Converter (OME) calculated? What is the core formula?
- 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.
- When is Opioid Equianalgesic Converter (OME) used?
- Opioid rotation and OME calculation for chronic pain and palliative care. Excludes methadone, fentanyl and buprenorphine, which convert non-linearly and need specialist handling.
- What are the key clinical points for Opioid Equianalgesic Converter (OME)?
- 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.
- What are the limits and cautions when using Opioid Equianalgesic Converter (OME)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.