Diamorphine hydrochloride is sometimes preferred, because being more soluble, it can be given in a smaller volume. The dose is given either as an immediate-release preparation 4-hourly or as a modified- release preparation hourly, in addition to rescue doses. Administration during labour may cause respiratory depression in the neonate and gastric stasis during labour, increasing the risk of inhalation pneumonia. Marketing authorisation holder 8. It is important not to become pregnant while having diamorphine. Keep container in the outer carton.

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A suitable laxative should be prescribed routinely.


It is important to let them know. Call freephone or email us. Families should be included in the care of the patient if they wish. Diamorphine should not be given to women who are breast-feeding as there is limited information available on diamorphine in breast milk. In theory injections dissolved in water for injections are more likely to be associated with pain possibly owing to their hypotonicity. The dose and duration of concomitant use should be limited see section 4.

Date of revision of the text.

If breakthrough pain occurs give a subcutaneous preferable or intramuscular injection of diamorphine equivalent to one-sixth of the total hour subcutaneous infusion dose. Lower starting doses are recommended for patients with hepatic or renal impairment. This information is intended for use by health professionals.

Morphine is also available for rectal administration as suppositories; alternatively oxycodone hydrochloride suppositories can be obtained on special order. If treatment continues for more than 24 hours it may be appropriate to use a syringe driver Burne R, Hunt A, Palliative Medicine1, Children and Elderly: Oral medication is usually satisfactory unless there is severe nausea and vomiting, dysphagia, weakness, or coma, when parenteral medication may be necessary.


Ketamine is sometimes used under specialist supervision for neuropathic pain that responds poorly to opioid analgesics. A nurse changes the pump every 24 to 48 hours. Metoclopramide hydrochloride has a prokinetic action and is used by mouth for nausea and vomiting associated with gastritis, gastric stasis, and functional bowel obstruction.

Care is required to avoid the discomfort of dry mouth. When oral medication is no longer possible, diazepam given rectally, or phenobarbital by injection diajorphine continued as prophylaxis. It is important not to become pregnant while having diamorphine.

Nausea and vomiting may occur with opioid therapy particularly in the initial stages but can be prevented by giving an antiemetic such as haloperidol or metoclopramide hydrochloride.

Or you may have it through a central line, a portacath or a PICC line. Care needs to be taken with unconscious intensive care patients on fixed dose schedules where their renal function is impaired. Many patients wish to remain at home with their families.

Diamorphine Hydrochloride BP 100 mg Lyophilisate for Solution for Injection

Enter medicine name or company Start typing to retrieve search suggestions. Or the nurse may teach you or your carer how to do this.

Pain management in palliative care is focused on achieving control of pain by throuth the right drug in the right dose at the right time.


Constipation is a common cause of distress and is almost invariable after administration of an opioid analgesic. It is used for nausea and vomiting due to mechanical bowel obstruction, raised intracranial pressure, and motion sickness. A dose of 0.

Prescribing in palliative care | Medicines guidance | BNF content published by NICE

When adjusting the dose of morphinethe number of rescue doses required and the response to them should be taken into account; increments of morphine should not exceed one-third to one-half of the total daily dose every 24 hours.

Hospice care of terminally ill patients has shown the importance of symptom control and psychosocial support of the patient and family. Company contact details Accord-UK Ltd. Report a side effect to the MHRA.

If breakthrough pain occurs give a subcutaneous preferable or intramuscular injection equivalent to one-tenth to one-sixth of the total hour subcutaneous infusion dose. If non-opioid analgesics alone are not sufficient, then an opioid analgesic alone or in combination with a non-opioid analgesic at an adequate dosage, may be helpful in the control of moderate pain.

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