Muscle spasm The pain of muscle spasm can be helped by a muscle relaxant such as diazepam or baclofen. If affected patients should not drive or use machines. Lower starting doses are recommended for patients with hepatic or renal impairment. As diamorphine has a respiratory depressant effect, care should be taken when giving the drug to the very young and the elderly and a lower starting dose than normal is recommended. Chronic pain , mg regularly every four hours by subcutaneous or intramuscular injection. Fentanyl equivalences in this table are for patients on well-tolerated opioid therapy for long periods; for patients who are opioid naive or who have been stable on oral morphine or other immediate release opioid for only several weeks, see Transdermal Route.

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Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Prophylactic treatment with phenytoin or carbamazepine should be considered. This information is intended for use by health professionals. Initiation of an opioid analgesic should not be delayed by concern over a theoretical likelihood of psychological dependence addiction. By continuing to browse the site you are agreeing to our policy on the use of cookies.

Find out more here. Provided that there is evidence of compatibility, selected injections can be mixed in syringe drivers. Hiccup Hiccup due to gastric distension may be diwmorphine by a preparation incorporating an antacid with an antiflatulent. Staff using syringe drivers should be adequately trained and different rate settings should be clearly identified and differentiated ; incorrect use of syringe drivers is a common cause of medication errors.

Restlessness and confusion may require treatment with an antipsychotic, dizmorphine. Increments should be made to the dose, not to the frequency of administration. Palliative care is an approach that improves the quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.


You usually have it in your buttocks or upper thigh. Diamorphine has been administered in reduced doses to children with neoplastic disease when it becomes difficult to give treatment orally. Hospice care of terminally ill patients has shown the importance of symptom control and psychosocial support of the patient and family. As diamorphine has a respiratory depressant effect, care should be taken when giving the drug to the very young and the elderly and a lower starting dose than normal is recommended.

Not all types of medication can be used in a subcutaneous infusion. Read more about the different types of painkillers.

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

Continuous subcutaneous infusion should be monitored regularly both to check for precipitation and discoloration and to ensure that the infusion is running at the correct rate. 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.

Hyperpyrexia and CNS toxicity have been reported when opioid analgesics are used with selegiline. It is predominantly a central nervous system depressant but it has stimulant actions resulting in nausea, vomiting and miosis. During the titration phase the initial dose is based on the previous medication used, the severity of the pain, and other factors such as presence of renal impairment, increasing age, or frailty.


You usually have it through a thin, short tube a cannula put into a vein in your arm or the back of your hand. Octreotidewhich stimulates water and electrolyte absorption and inhibits water secretion in the small bowel, can be syribge by subcutaneous infusion to reduce intestinal secretions and to reduce vomiting due to bowel obstruction.

Mixing and compatibility The general principle that injections should be given into separate sites and should not be mixed does not apply to the use of syringe drivers in palliative care. The patients should be followed trough for signs and symptoms of respiratory depression and sedation. Class 1 glass ampoules containing mg Diamorphine Hydrochloride BP lyophilisate each.

If symptoms persist, they can be given regularly via a continuous infusion device. 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: If the patient becomes unable to swallow, generally morphine is administered as a continuous subcutaneous infusion for details, see Continuous Subcutaneous Infusions below. Cyclizine is given by mouth.

Skip to main content. It is important not to become pregnant while having diamorphine. Analgesics can be divided into three broad classes: Capillary bleeding Capillary bleeding can be treated with tranexamic acid by mouth; treatment diamoephine usually discontinued one week after the bleeding has stopped, or, if necessary, it can be continued at a reduced dose.