Paediatric Palliative Care Guidelines
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Edition/Revision: 1.0

Alternatives to morphine - Archived

  • Diamorphine:  Similar characteristics to morphine except that it is highly hydrophilic  and has increased solubility.  This confers a significant clinical advantage in that large doses can be given in small volumes and makes it the drug of choice for IVSC administration.  1.5 – 2 x as potent as morphine when given by the same route.
  • Fentanyl:  Highly lipophilic synthetic mu-agonist with around 150 x the potency of morphine.  It is wholly synthetic and a different class to morphine, therefore suitable for opioid rotation where adverse effects of opiates have become dose limiting.  Available in transdermal, intranasal and parenteral forms.  It has a smaller half life than morphine.
  • Buprenorphine:  Partial mu agonist with mixed agonist and antagonis properties.  Available as a sublingual and transdermal formulation (see earlier notes).
  • Methadone, hydromorphone and oxycodone are used rarely in children and should be considered only in discussion with the specialist paediatric palliative care team.
Edition/Revision: 1.0
Created 18 Jul 2013 - Archived
Validated 19 Jul 2013 by Ian Back
Last modified 26 Feb 2024
Sat 02 Mar 2024 23:31:50 GMT
Last modified 26 Feb 2024