analgesia for breakthrough pain

Last reviewed 01/2018

  • always make sure that appropriate medication is available to treat breakthrough pain

  • this should be equivalent to a 4-hourly dose (recommended dose of normal release morphine for breakthrough pain is the equivalent up to one sixth of the total 24 hour morphine dose)

  • examples:
    • for a daily dose is MST 30mg bd, breakthrough pain dose is 60/10mg = 10mg 4-hourly prn
    • for MST 600mg bd, breakthrough pain dose is 1200/6mg = 200mg 4-hourly prn


  • (1) West Midlands Palliative Care Physicians (2007). Palliative care - guidelines for the use of drugs in symptom control.