Simple analgesics and weak opiates in palliative care
Regular doses of simple analgesics or weak opiates will often make the use of strong opiates unnecessary:
Non-opiates 4-6hourly:
- paracetamol 1G
Weak opiates for use 4-6 hourly include:
- co-codamol 8/500 and 30/500 (Tylex, Solpadol)
- co-dydramol 10/500 and 20/500 (Remedeine)
- dihydrocodeine (DHC) 30mg
- tramadol 50-100mg
Weak opiates for use 12-hourly include:
- DHC continus 60 and 120mg
- tramadol SR 100-200mg (=1/4 strength of morphine)
Notes:
- compound preparations of paracetamol and weak opioids may be useful. However only preparations with higher doses of opioids (codeine 30mg, dihydrocodeine 20-30mg) should be used, as the lower strength preparations produce opioid side effects with little analgesia (1).
Reference:
- West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptom control.
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