Opioids in palliative care

Regular around-the-clock dosing with breakthrough doses available, usually 10 % of the total daily dose, as often as needed. If several breakthrough doses are needed each day, the regular dose is too low. Always prescribe a laxative alongside: opioid constipation does not resolve with tolerance, unlike nausea and sedation which fade in a few days. Respiratory depression at end of life is far rarer than untreated pain. Sedation increases before the respiratory rate falls, so monitor sedation.

Clinical content reviewed by Ducamelle Louis, Registered Nurse