• In order to achieve rapid, effective, and safe pain control in adults (including the elderly) and adolescents with cancer, treatment needs to begin with the use of NSAIDs, paracetamol, and opioids, either alone or in combination depending on clinical assessment and pain severity.
• Any opioid may be considered for maintenance of pain relief, depending on clinical assessment and pain severity.
• Use regularly dosed immediate-release oral morphine, or regularly dosed slow-release morphine, to maintain effective and safe pain relief. Use immediate-release oral morphine as rescue medicine with either formulation.
• The subcutaneous route is preferred over intramuscular injection when oral or transdermal routes are not possible.
• Use adjuvant steroids to achieve pain control when indicated in adults (including the elderly) and adolescents with pain related to cancer.
• Use a bisphosphonate to prevent and treat bone pain in adults (including the elderly) and adolescents with bone metastases.
• Use a single-dose fractionated radiotherapy when radiotherapy is indicated and available in adults (including the elderly) and adolescents with pain related to bone metastases.
See reference for more information.
WHO Guidelines for the pharmacological and radio therapeutic management of cancer pain in adults and adolescents
Adapted from Medscape Drugs & Diseases. Cancer Pain Management Clinical Practice Guidelines. 2019. Available at https://reference.medscape.com/viewarticle/909653. Internet. Accessed on July 30, 2019. To view the entire article and all other content on the Medscape Drugs & Diseases site, a free, one-time registration is required.