Morphine Equivalent of 8 mg Hydromorphone
8 mg of hydromorphone equals 32 mg of morphine milligram equivalents (MME). 1
Calculation Method
The CDC Guideline for Prescribing Opioids for Chronic Pain establishes that hydromorphone has a conversion factor of 4 when calculating morphine milligram equivalents. 1
To calculate the MME, multiply the hydromorphone dose by the conversion factor: 8 mg × 4 = 32 mg MME. 1, 2
This conversion factor applies regardless of whether you're calculating total daily dose or comparing single doses for equivalency purposes. 1
Route-Specific Considerations
The 4:1 conversion ratio (hydromorphone to morphine) is the standard for calculating MME across all routes of administration. 1, 2
When specifically converting IV morphine to IV hydromorphone in clinical practice (not just calculating MME), a 5:1 ratio is recommended (10 mg IV morphine = 2 mg IV hydromorphone), which reflects the approximately 5-7 times greater potency of hydromorphone compared to morphine. 3, 4
For oral to oral conversions in clinical opioid rotation, ratios ranging from 5:1 to 8:1 (morphine to hydromorphone) have been studied, with 5:1 being most commonly recommended. 3, 5
Critical Safety Caveat
These conversion factors are specifically for calculating MME for comparison purposes and may differ from equianalgesic dosing when actually switching patients between medications. 2
When converting between opioids in clinical practice (as opposed to simply calculating equivalents), reduce the calculated dose by 25-50% to account for incomplete cross-tolerance. 4, 6
Equianalgesic dose conversions are only estimates and cannot account for individual variability in genetics and pharmacokinetics. 1