Which opioids can be used in renal impairment?

Opioids are used in a wide variety of clinical settings and are well established for the treatment of both acute and chronic pain. Renal impairment…

What is the risk of interaction between opioids and monoamine oxidase inhibitors (MAOIs)?

This article considers the risks of interaction between opioids and monoamine oxidase inhibitors. The use of MAOIs with opioids is contraindicated or cautioned by manufacturers.…

How should medicines be dosed in children who are obese?

Obesity results in physiological changes that can affect the volume of distribution and the clearance of drugs. The extent of these changes is variable and…

How should conversion from oral morphine to fentanyl patches be carried out?

This updated Medicines Q&A considers the factors which need to be considered when converting patients from oral morphine to fentanyl patches.   Explicit guidance on…

What naloxone doses should be used in adults to reverse urgently the effects of opioids or opiates?

The opioid and opiate antagonist, naloxone, is a highly effective antidote the use of which is potentially life-saving. The drug has a role in a…

What are the equivalent doses of oral morphine to other oral opioids when used as analgesics in adult palliative care?

Morphine is generally the strong opioid of choice for treating moderate to severe cancer pain and a common question is how to convert a dose…

Who can supply or administer Controlled Drugs under the terms of a Patient Group Direction and under what circumstances?

The use of controlled drugs is regulated under the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001 (as amended). Currently, the…

Can opioids be used for pain relief during pregnancy?

There are no specific guidelines for the treatment of pain in pregnancy. Not all analgesics are suitable for use during or at certain stages of…

Safety in Lactation: Opioid analgesics

The evidence relating to the safe use of opioid analgesics in breastfeeding mothers is very variable between individual drugs. This group of drugs presents a…