What is it? | Opioid analgesic |
Mechanism of action | Mu opioid agonist |
Starting dose | 1.25–2.5 mg given as drops, maximum 1 hourly |
Time to effect | Uncertain (20–30 min with oral route)17
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Formulation | OxyNorm Concentrate 10 mg/mL oral solution |
Indication | Pain, breathlessness |
Common adverse effects | ‘Anxiety; bronchospasm; depression; diarrhoea; dyspnoea; gastrointestinal discomfort; hiccups; mood altered; tremor’16
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Contraindications | ‘Acute abdomen; chronic constipation; cor pulmonale; delayed gastric emptying’16
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Caution | See Direct.gov.uk for Drug Driving advice |
Licencing | ‘Off label’ route of licensed oral solution |
Benefits | A transmucosal alternative to oral or subcutaneous morphine |
Risks | Unpredictability of bioavailability when sublingual or buccal route used, likely lower than oral due to solution not being lipophilic |
Cost | £46.63 for 120 mL × 10 mg/mL oral solution |