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Palliative cancer care - pain - Management
Strong opioid: oral morphine

Age from 16 years onwards
Opioid naive: start oral morphine
Age: from 16 years onwards
Licensed use: no
Patient information: In elderly people or frail people, start with morphine 2–5 mg every 4 hours and as required (up to 2-hourly) for breakthrough pain.
In young and middle-aged people, start with morphine 5–10 mg every 4 hours and as required (up to 2-hourly) for breakthrough pain.
On weak opioid: start oral morphine
Age: from 16 years onwards
Licensed use: no
Patient information: For people previously on a weak opioid (e.g. codeine), start immediate-release morphine 10 mg every 4 hours and as required (up to 2-hourly) for breakthrough pain, or modified-release morphine 20–30 mg every 12 hours and 10 mg immediate-release morphine as required (up to 2-hourly) for breakthrough pain.
Consider starting at a lower dose and titrating carefully if the person is elderly or frail.

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