Palliative care 2017

Controlled release morphine

• 8 hourly, 12 hourly or 24 hourly

• If switching from 4 hourly morphine start from same total 24 hour dose as immediate release morphine once dose requirements defined by titration • No loading dose required

• Ensure breakthrough morphine also available • Anticipate slow increase in morphine dose with time

• Median dose in advanced cancer 40-60mg 4 hourly