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Loss of control of pain

Authoring team

There is no upper limit for strong opiates in palliative care but if the pain is not controlled despite rapidly escalating doses consider:

  • fracture or impending fracture
  • hypercalcaemia, a common cause of worsening bone pain
  • urinary retention
  • constipation
  • compliance: patients may dislike opiate owing to nausea, sedation, confusion, groundless fears or uncertainty as to the dose
  • failure to absorb eg vomiting
  • neuropathic origin of pain
  • new or other pathology, related or unrelated to cancer such as angina
  • depression or psychological distress

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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