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Palliative cancer care - pain - Management
Diamorphine for acute pain

Age from 16 years onwards
Opioid naive: diamorphine 1.25mg s/c or i/v injection
Diamorphine 5mg powder for solution for injection ampoules
Give 1.25mg by subcutaneous or intravenous injection.
Supply 1 ampoule.
Age: from 16 years onwards
NHS cost: £2.69
Licensed use: yes
Patient information: Prescription requirements apply.
Opioid naive: diamorphine 2.5mg s/c or i/v injection
Diamorphine 5mg powder for solution for injection ampoules
Give 2.5mg by subcutaneous or intravenous injection.
Supply 1 ampoule.
Age: from 16 years onwards
NHS cost: £2.69
Licensed use: yes
Patient information: Prescription requirements apply.
Already taking regular opioid
Age: from 16 years onwards
Licensed use: no
Patient information: If the person is already taking a regular opioid, calculate the 4-hourly dose by taking the total dose given over the previous 24 hours (including doses required for breakthrough pain but excluding those for incident pain) and dividing it by six, and then give the equivalent subcutaneous dose of diamorphine or morphine:
The subcutaneous dose of diamorphine is one third of the 4-hourly oral morphine dose.
The subcutaneous dose of morphine is approximately half of the 4-hourly oral morphine dose.

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