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Simple analgesics and weak opiates in palliative care

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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