oral opiate analgesia

Last reviewed 01/2018

Morphine is the preferred strong oral opiate.

Two formulations of morphine are sufficient:

• immediate release e.g. oromorph
• controlled release e.g. MST Continus

The required dose of analgesia is determined by the following method:

• decide on an appropriate dose of immediate release morphine (5-10 mg) which is given four-hourly
• break-through pain is controlled with the same dose which may be given as frequently as once hourly
• each day the four-hourly dose is adjusted according to the total morphine requirement of the previous day
• once pain is controlled with immediate release morphine, the same dose is prescribed in two divided doses as a controlled release preparation