MS Contin 120 mg Daily Dose = 120 MME
MS Contin (morphine sulfate controlled-release) 120 mg per day equals 120 MME per day, as morphine has a conversion factor of 1. 1
Calculation Method
The CDC guideline provides the standard conversion table: morphine has a conversion factor of 1.0 to calculate MME. 1
To determine MME, multiply the total daily morphine dose by the conversion factor: 120 mg × 1 = 120 MME per day. 1
Clinical Significance of This Dose
This 120 MME daily dose exceeds the CDC's 90 MME threshold, which requires careful justification and heightened monitoring for overdose risk. 1
The CDC guideline recommends careful reassessment of individual benefits and risks when prescribing ≥50 MME per day, and advises avoiding or carefully justifying doses ≥90 MME per day due to increased overdose mortality. 1
At 120 MME daily, this patient requires enhanced risk mitigation strategies including more frequent follow-up, prescription drug monitoring program checks, and consideration of naloxone co-prescription. 1
Important Caveats About MME Calculations
Equianalgesic dose conversions are only estimates and cannot account for individual variability in genetics and pharmacokinetics. 1
Do not use the calculated MME dose to determine doses when converting from one opioid to another—the new opioid should typically be dosed substantially lower than the calculated MME to avoid accidental overdose due to incomplete cross-tolerance. 1
MS Contin is an extended-release formulation designed for twice-daily dosing (e.g., 60 mg every 12 hours to achieve 120 mg daily), which provides more stable plasma concentrations compared to immediate-release morphine. 2, 3, 4