Page 35 - CPG - Clinical Practice Guidelines - Management of Cancer Pain

Management of Cancer Pain (Second Edition)
Other results of the above review were:
{ oral morphine was as effective as other opioids when used at the
correct dose as no conclusive evidence was found on other strong
opioids being superior in effectiveness to morphine
{ no difference in pain relief between immediate-release (IR) and
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{ no conclusive evidence on the effectiveness of double bedtime
dose of IR morphine to improve pain relief and prevent the patients
receiving 4-hourly dosing from being woken up at night
The quality of the evidence was generally poor with some studies being
old, small and designed for registration purposes.

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formulation, should be used to maintain effective and safe pain relief
in cancer pain. IR morphine should be used as rescue medicine with
either formulation. Thus, IR morphine must be available and accessible
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available as an addition to IR morphine. 11
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and 12 hours respectively. 34
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and CR oral formulations. A recent Cochrane review on adult cancer
pain found that there was little to no difference in pain intensity, pain
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morphine. The review also found that constipation and hallucinations
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certainty of the evidence was either very low or unstable with sensitivity
analysis. 35, level I

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fashion with a rapid phase half-life of 37 minutes (accounting for 38%
of the dose) and a slow phase half-life of 6.2 hours (which accounts
for the residual 62%). This allows the onset of analgesia using CR

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