From the Guidelines
The Morphine Milligram Equivalent (MME) for 30mg OxyContin (oxycodone) ER twice a day is 90 MME per day. This calculation is based on the conversion factor of 1.5 for oxycodone, as outlined in the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1. To calculate the MME, we first determine the total daily dose of oxycodone, which is 30mg twice daily, resulting in a total of 60mg of oxycodone per day. Multiplying this by the conversion factor of 1.5 gives us 90 MME per day.
The importance of MME calculations lies in assessing the relative potency of different opioid medications, which helps healthcare providers monitor the total opioid burden to minimize risks of adverse effects, including respiratory depression and potential for dependence 1. It's crucial to note that the CDC recommends caution when prescribing opioids at or above 50 MME per day, with careful justification needed for doses at or above 90 MME per day due to increased risk of overdose 1.
Key points to consider in opioid prescribing include:
- Using the lowest effective dose for the shortest duration necessary
- Carefully evaluating the benefits and risks of opioid therapy
- Implementing strategies to mitigate risks, such as close monitoring and use of prescription drug monitoring programs
- Considering alternative pain management strategies when possible
- Being aware of the potential for individual variability in opioid response and the need for cautious dose titration 1.
Given the potential risks associated with high MME doses, healthcare providers should regularly review and adjust opioid prescriptions as necessary to ensure that the benefits of pain relief are balanced against the risks of opioid-related adverse effects 1.
From the Research
Morphine Milligram Equivalent (MME) Calculation
To calculate the MME for 30mg OxyContin (oxycodone) ER twice a day, we need to understand the conversion factor between oxycodone and morphine.
- The conversion factor is not explicitly stated in the provided studies, but according to general guidelines, 1mg of oxycodone is equivalent to approximately 1.5mg of morphine 2.
- However, another study suggests that the conversion factor may vary, and a more commonly used conversion factor is 1mg of oxycodone being equivalent to 1.5-2mg of morphine, but a specific conversion factor of 1.5 is not mentioned in this study 3, 4.
- A study from 2019 discusses calculating the maximum morphine equivalent daily dose (MEDD) from prescription directions, but it does not provide a specific conversion factor for oxycodone to morphine 5.
- Another study from 2004 provides information on the dosing of sustained-release oxycodone, but it does not provide a direct conversion factor to morphine 2.
- A study from 1989 discusses the clinical pharmacology of controlled-release oral morphine, but it does not provide information on the conversion factor between oxycodone and morphine 6.
Calculation
Assuming a conversion factor of 1.5 (1mg oxycodone = 1.5mg morphine), we can calculate the MME as follows:
- 30mg OxyContin (oxycodone) ER twice a day = 60mg oxycodone per day
- Using the conversion factor: 60mg oxycodone per day * 1.5 = 90mg morphine per day
Result
The MME for 30mg OxyContin (oxycodone) ER twice a day is approximately 90mg morphine per day, based on the assumed conversion factor. However, please note that the actual conversion factor may vary, and this calculation is for illustrative purposes only. It's essential to consult a healthcare professional for accurate calculations and guidance.