Bedside steps

1. 1
   Opioid equiv

   Convert daily opioid doses between agents via oral morphine equivalents (OME), with an incomplete cross-tolerance reduc…

   Calculate here · Opioid equiv ▾Full details →
2. 2
   Benzo equiv

   Convert between benzodiazepines by diazepam equivalents, for switching and tapering (long-acting substitution for short…

   Calculate here · Benzo equiv ▾Full details →
3. 3
   Vancomycin

   Empiric vancomycin loading dose, maintenance dose and interval by weight and creatinine clearance (AUC-guided; requires…

   Calculate here · Vancomycin ▾Full details →
4. 4
   APAP safetyAlternate branch

   Check acetaminophen daily/single-dose limits and whether an acute ingestion reaches the toxic threshold or warrants NAC.

   Calculate here · APAP safety ▾Full details →
5. 5
   AminoglycosideAlternate branch

   Gentamicin/tobramycin/amikacin high-dose extended-interval (once-daily) empiric dosing by dosing weight and CrCl; requi…

   Calculate here · Aminoglycoside ▾Full details →

[Medication safety / dosing · bedside workflow]
Opioid equiv：not calculated
Benzo equiv：not calculated
Vancomycin：not calculated
APAP safety：not calculated
Aminoglycoside：not calculated
Guideline：Med safety / TDM / QTc (see tool pages for exact version notes)
Reviewed：2026-09-05
For licensed clinicians only. Local calculation; does not replace clinical judgment or individualized shared decision-making. Integrate guideline version, patient preference, and bleed–thrombosis trade-offs.

For licensed clinicians only. Local calculation; does not replace clinical judgment or individualized shared decision-making. Integrate guideline version, patient preference, and bleed–thrombosis trade-offs.