Current Opioid (FROM)
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MME Conversion Factors
| Opioid | Route | MME Factor | Notes |
|---|
| Morphine | Oral | 1 MME/mg | Reference standard |
| Morphine | IV/IM | 3 MME/mg | 3x more potent than oral |
| Oxycodone | Oral | 1.5 MME/mg | — |
| Hydrocodone | Oral | 1 MME/mg | — |
| Hydromorphone | Oral | 4 MME/mg | — |
| Hydromorphone | IV | 20 MME/mg | High potency — caution |
| Codeine | Oral | 0.15 MME/mg | Prodrug; variable CYP2D6 |
| Fentanyl Patch | Transdermal | 2.4 MME/mcg·h | Per mcg/h of patch rate |
| Tramadol | Oral | 0.1 MME/mg | Mixed MOR/SNRI mechanism |
| Tapentadol | Oral | 0.4 MME/mg | MOR/NRI mechanism |
Safety Warning: Apply 25–30% dose reduction when rotating between opioids (incomplete cross-tolerance). MME >50/day: elevated overdose risk. MME >90/day: high risk — avoid if possible; ensure naloxone prescribed. Fentanyl patch: 1 mcg/h transdermal ≈ 2.4 MME/day.
