OPIOID CALCULATOR

for calculation of oral Morphine Equivalent Daily Dose (MED) in mg/day

British Pain Society maximum recommended dose in chronic pain is 120mg MED per day*
(this limit does NOT apply in acute or palliative pain)

insert the dose of the drug under the name, and the number of doses per day for each drug used
(these conversion doses are approximate and assume long term use)

MORPHINE
Morphine doses/day MED Morphine liquid doses/day MED Morphine tablets doses/day MED subtotal MED
modified release (mg) immediate release (mg) immediate release (mg)
0 0 0 0
OXYCODONE / HYDROMORPHONE
Oxycodone doses/day MED Oxycodone doses/day MED Hydromorphone (mg) doses/day MED subtotal MED
modified release (mg) immediate release (mg)
0 0 0 0
FENTANYL **
Fentanyl patch MED Actiq® doses/day MED **There are no safe conversion directions available for transmucosal
(micrograms/hour) (micrograms) fentanyl products. This a calculation based on Actiq bioavailability and
0 0 is ONLY AN APPROXIMATE GUIDE to morphine equivalence
WEAK OPIOIDS
Tramadol (mg) doses/day MED Codeine (mg) doses/day MED Dihydrocodeine (mg) doses/day MED subtotal MED
0 0 0 0
BUPRENORPHINE
BuTrans® patch MED Transtec® patch MED sublingual tablet doses/day MED subtotal MED
(micrograms/hour) (micrograms/hour) (micrograms)
0 0 0 0
 TOTAL ORAL MORPHINE EQUIVALENT DOSE in mg/day 0

Notes:
morphine x1 Modified release morphine - MST®/Zomorph®/Morphgesic®/Filnarine® Immediate release morphine - Oramorph® (oral solution)/Sevredol® (tablets)
oxycodone x2 Modified release oxycodone - Oxycontin®/Longtec® Immediate release oxycodone - Oxynorm®/Shortec®
fentanyl patch [1] x 60/25
fentanyl lollipops - Actiq®[2] x 0.15 ** For conversion of other fentanyl formulations please contact OUH pharmacy on 21505 or MedicinesInformation@oxnet.nhs.uk
tramadol [3] x 0.1
codeine [3] x 0.1 References:
dihydrocodeine [1] x 0.1 1. BNF https://www.evidence.nhs.uk/formulary/bnf/current/guidance-on-prescribing/prescribing-in-palliative-care/pain/pain-management-with-opioids
hydromorphone [1] x5 2. Actiq SPC http://www.medicines.org.uk/emc/medicine/30547
Butrans® buprenorphine patch [1]
x 12/5 3. GP notebook http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20041106080808159860
Transtec® buprenorphine patchx[1]84/35 4. MIMS http://www.mims.co.uk/opioid-analgesics-approximate-potency-equivalence-oral-morphine/pain/article/1146201
buprenorphine tablets [4] x 0.06
*http://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware

Template prepared by Dr Jane Quinlan, consultant in anaesthesia and pain management

on behalf of the pain service of the Oxford University Hospitals NHS Foundation Trust
with thanks to David Hutchings, Lead Medicines InformationPharmacist
date Dec 2017 review 2020 version 1.2