How do I switch from oral morphine to another strong opioid?
Undesirable effects, such as nausea or drowsiness, can occur on starting an opioid or with a dose increase. These may require the use of additional medication, such as anti-emetics, but generally resolve after about 1 week. Occasionally, the dose of opioid may need to temporarily be reduced and titrated up again more slowly. If severe or persistent undesirable effects occur, seek specialist advice, as an alternative opioid may be required. Oral morphine to another oral strong opioid • CKS recommends that primary care healthcare professionals seek specialist advice, or consult local guidelines (where available), when selecting the opioid and dose to switch to because experience in primary care is likely to be limited and alternative oral opioids are best initiated by a person with experience in palliative care. Methadone should only be initiated by a specialist because it has a long and unpredictable half-life, with considerable inter-individual variation, and requires careful monitorin
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