Analgesia

Opioid Ramp & Taper Helper

Use your patient's current opioid regimen and 24-hour MME to plan cautious dose increases or tapers. The tool shows its math and nudges toward multimodal analgesia; it does not replace clinical judgment or local policies.

This tool is a dose-planning aid and does not replace clinical judgement. Always verify calculations and consider patient-specific factors.

Baseline opioid regimen & 24-hr MME

Enter an existing inpatient regimen or patient’s most recent 24-hour MME.

Enter the patient’s exact opioid regimen to generate a tailored ramp/taper plan for each medication.

Paste inpatient opioid regimen

Paste PHI-free medication list directly into text-box or select 'enter manually' to add meds using a drop-down menu.

Regimen text (one line per opioid works best)

OME breakdown

Tylenol/day: 0 mg

Dosing equivalents (reference)

Agent	PO dose	IV dose
Morphine	30 mg	10 mg
Hydromorphone	7.5 mg	1.5 mg
Oxymorphone	10 mg	1 mg
Meperidine	300 mg	75 mg
Fentanyl	—	0.1 mg
Oxycodone	20 mg	—
Hydrocodone	30 mg	—
Codeine	120 mg	—

Conversion factors are adapted from commonly used opioid equivalence charts, including the SinaiEM Opioid Conversion Chart (see image). Always verify with your institution's preferred reference.

Total estimated OME:~0 mg/day

Choose ramp or taper strategy

Set whether you’re escalating or tapering, how well pain is controlled, and how aggressive you’d like the change to be.

Mode:

Pain control on current regimen:

Multimodal regimen in place?

Escalation Presets:

Current setting: Moderate (≈20–35% increase)

+30%applied to total MME

Smaller changeLarger change

Most guidelines favor 5–20% changes per step; larger shifts may require closer monitoring.

24-hr MME (base → target)

0 → 0 MME/day

Approx 0% change; factor ≈ 1.00 applied to each dose.

Lower MME (demo)

Review suggested ramp/taper plan

See the calculated target MME and, when a regimen is entered, per-drug suggested dose changes.

Caution

Regimen entered but 24-hr MME is ~0 mg/day. Check doses and frequencies.

Multimodal regimen is not marked as in place. When safe, consider non-opioid adjuncts (e.g., acetaminophen, NSAIDs, neuropathic agents, regional techniques, non-pharmacologic measures) rather than escalating opioids alone.

Show calculation details

Baseline MME from regimen: ~0 mg/day.
Effective baseline used for planning: ~0 mg/day (manual override if provided > 0).
Scaling factor based on mode and slider: 1.00.
Target MME ≈ base × factor = 0 × 1.00 ≈ 0 mg/day.
Each complete regimen row's dose is multiplied by the same factor, then rounded to a practical mg amount.

Show references & guidance

CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022). CDC MMWR 71(3).
VA/DoD Clinical Practice Guideline for the Use of Opioids in the Management of Chronic Pain. VA/DoD COT guideline.
Morphine Milligram Equivalents (MME) Calculator. MDCalc MME calculator.
Visual equianalgesic chart similar to this tool's Dosing equivalents reference table: Sinai EM equianalgesic image.

This tool is meant as a structured thinking aid and does not replace institutional policies, guidelines, or bedside clinical judgment.