Rarely-needed opiates
Morphine, diamorphine and Fentanyl are easy to use and highly effective in the vast majority of patients and so other opiates are seldom used:
- methadone is used only if there are problems with morphine: beware of its very long half-life
- pethidine is not advised because of its short half-life and the problem of frequently repeated doses
- papaveretum (Omnopon) is not advised: it is a mixture of natural opiates
- buprenorphine (Temgesic) sublingually is occasionally helpful but antagonises other opiates
- dextromoramide (Palfium) has a very short half-life and may be used to cover painful procedures
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