How-to · CDC 2022 factors · Educational only · Updated October 2, 2026
How do you calculate MME?
Direct answer
MME/day = daily dose × CDC 2022 factor, then add every opioid. Oxycodone 10 mg twice daily is 20 mg × 1.5 = 30 MME/day. The total gauges exposure. CDC says it must not be used by itself to pick the dose when changing to another opioid.
CDC 2022 conversion factors
| Opioid | Factor | Unit |
|---|---|---|
| Oxycodone | 1.5 | mg/day |
| Hydrocodone | 1 | mg/day |
| Morphine (oral) | 1 | mg/day |
| Hydromorphone | 5 | mg/day |
| Oxymorphone | 3 | mg/day |
| Codeine | 0.15 | mg/day |
| Tramadol | 0.2 | mg/day |
| Tapentadol | 0.4 | mg/day |
| Methadone | 4.7 | mg/day |
| Fentanyl patch (transdermal) | 2.4 | mcg/hr |
| Buprenorphine | none | mg/day |
Source: CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022). MME, MED, and OME mean the same kind of oral-morphine total; tools differ when they use older factors.
Worked examples
- Oxycodone 10 mg twice daily: 20 × 1.5 = 30 MME/day. One 5 mg tablet is 7.5 MME.
- Hydrocodone 10 mg four times daily plus tramadol 50 mg twice daily: 40 + 20 = 60 MME/day (50–89 MME/day).
- Hydromorphone 4 mg every 6 hours: 16 mg/day × 5 = 80 MME/day. The 2016 factor was 4, which would understate this by 20%.
- Methadone 10 mg three times daily: 30 × 4.7 = 141 MME/day for exposure only. Switching onto methadone is a specialist protocol, not this multiplication.
What the total is compared with
- < 50 MME/day. CDC: use caution at any dosage and prescribe the lowest effective dose. Overdose risk still rises with dose and with benzodiazepines, alcohol, or sleep apnea.
- 50–89 MME/day. CDC: pause and carefully reassess benefits and risks before increasing; offer naloxone; follow up more often. Overdose risk is about double at 50 to <100 MME/day versus <20 MME/day.
- 90–199 MME/day. Few trials studied doses ≥90 MME/day and added benefit is not established. Medicare Part D plans run a pharmacist care-coordination edit at 90 MME/day. Do not taper abruptly.
- ≥ 200 MME/day. Medicare Part D plans may apply an optional hard edit at 200 MME/day. CDC warns against rapid tapers or abrupt discontinuation unless there are warning signs of impending overdose.
Limits
- This is education for reviewing a listed regimen. It is not a prescription or a taper plan.
- Do not use the MME total alone to start a different opioid. Cross-tolerance is incomplete.
- Buprenorphine is excluded. IV fentanyl and IV morphine use hospital tables, not these factors.
- Benzodiazepines, alcohol, and sleep apnea raise overdose risk at any MME. Suspected overdose: call 911 and give naloxone.
Use the calculator
Patch strengths: how many MME is a fentanyl patch? Add a regimen in the MME calculator.