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Oral opiate analgesia

Authoring team

Morphine is the preferred strong oral opiate.

Two formulations of morphine are sufficient:

  • immediate release e.g. oromorph
  • controlled release e.g. MST Continus

The required dose of analgesia is determined by the following method:

  • decide on an appropriate dose of immediate release morphine (5-10 mg) which is given four-hourly
  • break-through pain is controlled with the same dose which may be given as frequently as once hourly
  • each day the four-hourly dose is adjusted according to the total morphine requirement of the previous day
  • once pain is controlled with immediate release morphine, the same dose is prescribed in two divided doses as a controlled release preparation

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