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Controlled release morphine
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8 hourly, 12 hourly or 24 hourly
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If switching from 4 hourly morphine start from same
total 24 hour dose as immediate release morphine
once dose requirements defined by titration
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No loading dose required
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Ensure breakthrough morphine also available
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Anticipate slow increase in morphine dose with time
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Median dose in advanced cancer 40-60mg 4 hourly