Table 1a: Opioids
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Single drugs used in a subcutaneous infusion over 24 hours in palliative care (tables 1a to 1f) Diluent water for injection unless stated and make up to 17 ml in 20 ml in 30 ml syringe using a BD Bodyguard T pump or 24 ml or 48 ml in a 50 ml syringe in a non-ambulatory pump |
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Single agents |
Uses and typical dose ranges |
Comments |
| Table 1a: Opioids – refer to Choosing and Changing Opioids guideline | ||
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ALFENTANIL 1 mg in 2 ml 5 mg in 1 ml (use may be restricted in some areas) |
Opioid responsive pain, breathlessness Dose: Specialist advice and supervision required |
3rd line opioid, specialist advice needed 1st line in stages 4/5 chronic kidney disease Caution with high strength preparation (5 mg in 1 ml); only use in line with local policy |
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DIAMORPHINE 5 mg, 10 mg, 30 mg, 100 mg, 500 mg powder ampoules |
Opioid responsive pain, breathlessness Dose: 5 mg to 10 mg over 24 hours, if no opioid before |
Can be diluted in a small volume Preferred for high opioid doses Caution in stage 4/5 chronic kidney disease |
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HYDROPHORPHONE 10 mg in 1 ml 20 mg in 1 ml 50 mg in 1 ml |
Opioid responsive pain, breathlessness Dose: Specialist advice and supervision required
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3rd line opioid, specialist advice needed Caution in stage 4/5 chronic kidney disease |
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MORPHONE SULPHATE 10 mg, 30 mg in 1 ml
60 mg, in 2 ml (other strengths available but not used commonly) |
Opioid responsive pain, breathlessness Dose: 5 mg to 10 mg over 24 hours, if no opioid before
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1st line opioid analgesic Caution in stage 4/5 chronic kidney disease |
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OXYCODONE 10 mg in 1 ml 20 mg in 2 ml 50 mg in 1 ml (use may be restricted in some areas) |
Opioid responsive pain, breathlessness Dose: 2 mg to 5 mg over 24 hours, if no opioid before |
2nd line opioid analgesic if morphine / diamorphine not tolerated Caution in stage 4/5 chronic kidney disease |