From the Guidelines
The morphine equivalent dose for 10 milligrams of oxycodone is approximately 15 milligrams of morphine. This means that 10 mg of oxycodone provides pain relief roughly equivalent to 15 mg of morphine. According to the most recent and highest quality study 1, oxycodone has a conversion factor of 1.5, which is used to determine the morphine milligram equivalent (MME) dose. To calculate the MME dose, the dose of oxycodone is multiplied by the conversion factor. In this case, 10 mg of oxycodone would be equivalent to 10 mg x 1.5 = 15 MME.
Key Points to Consider
- The conversion factor for oxycodone is 1.5, as stated in the 2022 CDC clinical practice guideline for prescribing opioids for pain 1.
- This conversion is important when switching between opioid medications or calculating total opioid burden.
- Oxycodone is approximately 1.5 times more potent than morphine on a milligram-per-milligram basis, which explains this conversion ratio.
- When healthcare providers need to rotate opioids or assess overall opioid exposure, they use these equivalency calculations to maintain appropriate pain control while minimizing risks.
- It's worth noting that individual patient responses to opioids can vary based on factors like prior opioid exposure, age, and genetic differences in metabolism, so clinical monitoring is essential when making any opioid conversion in practice.
Clinical Application
- Healthcare providers should use the most recent and reliable conversion factors, such as those provided in the 2022 CDC guideline 1, to ensure accurate calculations.
- The MME dose should not be used to determine the doses to use when converting one opioid to another; instead, the new opioid should be dosed at a substantially lower dose than the calculated MME dose to avoid overdose due to incomplete cross-tolerance and individual variability in opioid pharmacokinetics.
From the FDA Drug Label
Name Equianalgesic Dose (mg) IM‡,§ PO Morphine 10 60 (30)¶ ... Oxycodone 15 30
The morphine equivalent dose for 10 milligrams of oxycodone is 20 mg of morphine, since 15 mg of oxycodone is equivalent to 30 mg of oral morphine, and using a conversion ratio, 10 mg of oxycodone would be equivalent to 20 mg of morphine 2.
From the Research
Morphine Equivalent Dose for Oxycodone
To determine the morphine equivalent dose for 10 milligrams of oxycodone, we need to consider the conversion ratios between different opioids.
- The study 3 suggests a 1:1 milligram conversion ratio for oral morphine and oral oxycodone, but also mentions that the milligram relative potency ratio for oral oxycodone to parenteral morphine during repeated dosing is 3:1, and another ratio of 2:1 for oral morphine to oral oxycodone can be inferred from other studies.
- However, a more comprehensive review 4 provides a synthesis of oral morphine equivalents (OME) for opioid utilization studies, which can be used to estimate the conversion factor.
- Based on the information provided in the studies, the conversion factor from oxycodone to morphine equivalent dose can be estimated as follows:
- 10 mg of oxycodone is approximately equal to 10-20 mg of oral morphine, considering the 1:1 to 1:2 conversion ratio.
- However, the exact conversion ratio may vary depending on the specific context and population being studied.
Key Findings
- The study 3 provides a case illustration of an opioid-tolerant cancer patient taking high doses of oral oxycodone, which supports the use of a 1:1 milligram conversion ratio for oral morphine and oral oxycodone.
- The review 4 provides a comprehensive synthesis of OME conversion factors, which can be used to estimate the conversion factor for oxycodone to morphine equivalent dose.
- It is essential to note that the conversion ratio may vary depending on the specific context and population being studied, and individual patient factors should be taken into account when converting between opioids.