MME Calculator
Add up a patient’s total daily opioid dose in morphine milligram equivalents (MME/day). Enter the total daily dose of any of the opioids below — you can combine several — and this calculator multiplies each by its CDC conversion factor and sums them, then shows where the total sits against the CDC caution thresholds of 50 and 90 MME/day. Methadone uses its dose-dependent factor automatically.
About morphine milligram equivalents
MME puts every opioid on a single morphine scale so a patient’s total daily dose can be tracked and compared with safety thresholds. It is a population and monitoring measure, and published conversion ratios are crude estimates — never a substitute for a proper conversion protocol when actually rotating opioids. Source: Dowell D et al., CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022, MMWR Recomm Rep 2022;71(3):1–95, and the CDC oral MME conversion-factor table.
Frequently asked questions
What is an MME (morphine milligram equivalent)?
A morphine milligram equivalent, or MME, converts a dose of any opioid into the amount of oral morphine that would be roughly equivalent in strength. It lets you add up several different opioids onto one scale — total MME per day — so the overall opioid burden can be compared between patients and against safety thresholds. MME per day = daily dose × the opioid’s conversion factor, summed across every opioid taken.
What are the CDC MME conversion factors?
The CDC analytic conversion factors are: codeine 0.15, hydrocodone 1, morphine 1, oxycodone 1.5, oxymorphone 3, hydromorphone 4, tapentadol 0.4, tramadol 0.1, and fentanyl transdermal patch 2.4 per mcg/hr. Methadone is dose-dependent: 4 for 1–20 mg/day, 8 for 21–40, 10 for 41–60 and 12 above 60 mg/day. So 40 mg/day of oxycodone is 40 × 1.5 = 60 MME/day.
What MME per day is considered high?
The 2022 CDC Clinical Practice Guideline avoids a single hard cutoff, but it flags that overdose risk rises with dose and highlights caution at 50 MME/day and above — where clinicians should reassess the benefits and risks. Many health systems and payers use 90 MME/day as a threshold that calls for extra justification, a taper discussion, or specialist input. This calculator marks both 50 and 90 MME/day on the scale. Higher totals mean higher risk, not an automatic ceiling.
Can I use MME to switch a patient from one opioid to another?
No — MME is designed for measuring and monitoring total daily dose, not for direct opioid rotation. Published equianalgesic ratios are crude estimates, incomplete cross-tolerance means the new opioid is usually started at a reduced dose, and methadone and buprenorphine in particular do not convert linearly. Use a dedicated conversion protocol and clinical judgement for any actual switch, and account for residual drug (for example, a fentanyl patch keeps releasing for 12–36 hours after removal).
Why isn’t buprenorphine included?
Buprenorphine is a partial agonist with a ceiling effect and is deliberately excluded from the CDC MME framework, so adding it to an MME total would be misleading. This calculator follows the CDC set and leaves it out. The tool is an educational reference, not medical advice — always confirm doses against your own formulary and clinical context.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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