Opioid Taper Calculator
Caution:
- Patients on methadone, buprenorphine or other complicated regimens, or who have significant comorbid mental health disorders should be referred for specialist consultation.
- This calculator is intended for use as a starting point for tapering chronic opioid therapy regimens. Tapering plan should be individualized based on the patient's goals and concerns. The longer the duration of opioid therapy, the longer the taper may take.
- Do not reverse the taper; rate may be slowed or paused while monitoring for and managing withdrawal symptoms.
- Watch for signs of unmasked mental health disorders during taper, especially in patients on prolonged or high dose opioids.
Symptoms and Treatment of Opioid Abstinence Syndrome (withdrawal):
- Restlessness, sweating, or tremors: Clonidine 0.1-0.2mg orally every 6 hours or transdermal patch 0.1-0.2mg weekly during taper. If patch is used, oral medication may be needed for the first 72 hours. Monitor for hypotension and anticholinergic side effects.
- Nausea: Antiemetics such as ondansetron or prochlorperazine
- Diarrhea: Loperamide or antispasmodics such as dicyclomine
- Muscle pain, neuropathic pain or myoclonus: NSAIDs, gabapentin or muscle relaxants such as cyclobenzaprine, tizanidine or methocarbamol
- Insomnia: Melatonin or sedating antidepressants (e.g. mirtazapine 15mg or trazodone 50mg at bedtime). Do not use benzodiazepines or sedative-hypnotics.
Opioid Taper Calculator
Please choose the taper order, rate, duration, and start date.
Please enter the current opioid regimen
Baseline Opioid
mg/ dose
Doses/ day
Current mg/day
Morphine Equiv.
% of Total