Instructions: Fill in the mg per day for the patient’s opioid medications. The daily morphine equivalent dose is calculated automatically.
| Opioid: | mg per day: | Morphine Equivalent Dose: |
|---|---|---|
| Codeine | ||
| Fentanyl transdermal (in mcg/hr) | ||
| Hydrocodone | ||
| Hydromorphone | ||
| Methadone | ||
| Morphine | ||
| Oxycodone | ||
| Oxymorphone | ||
| Tapentadol | ||
| Tramadol |
| Total | 0 |
|
|---|---|---|
Buprenorphine products approved for the treatment of pain are not included in the table because of their partial µ-receptor agonist activity and resultant ceiling effects compared with full µ-receptor agonists.