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Home Formulary 4.0 Central Nervous System 4.7 Analgesics 4.7.1 General management of acute pain 4.7.1.2 Opioid analgesics

4.7.1.2 Opioid analgesics

ChoiceDrug

1st choice

For acute management of severe pain before hospital admission

Morphine immediate release tablets; modified release tablets, capsules; oral solution; injection (see BNF for available strengths)

Prescribe modified release morphine preparations by brand name

Prescribing Notes

  • Morphine should be given parenterally when possible for acute severe pain. The first dose of intravenous morphine should be given slowly, titrated to effect, and respiratory rate monitored. For use of naloxone, see BNF.
  • Patients may be discharged following surgery on strong opioid analgesics. Treatment should be for short duration and patients should be reviewed before further medication is prescribed by primary care. Where necessary secondary care specialist(s) should be contacted about the treatment plan or patient’s reported pain. NICE have produced a visual summary for reviewing medication associated with dependence.

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