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Simple analgesics and weak opiates in palliative care

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Regular doses of simple analgesics or weak opiates will often make the use of strong opiates unnecessary:

Non-opiates 4-6hourly:

  • paracetamol 1G

Weak opiates for use 4-6 hourly include:

  • co-codamol 8/500 and 30/500 (Tylex, Solpadol)
  • co-dydramol 10/500 and 20/500 (Remedeine)
  • dihydrocodeine (DHC) 30mg
  • tramadol 50-100mg

Weak opiates for use 12-hourly include:

  • DHC continus 60 and 120mg
  • tramadol SR 100-200mg (=1/4 strength of morphine)

Notes:

  • compound preparations of paracetamol and weak opioids may be useful. However only preparations with higher doses of opioids (codeine 30mg, dihydrocodeine 20-30mg) should be used, as the lower strength preparations produce opioid side effects with little analgesia (1).

Reference:

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

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