Weak opioid medicines for pain relief

Opioid medicines are painkillers that are based on morphine or similar to morphine. Some are weaker and some are stronger, depending on your needs.

Doctors often prescribe opioids along with other painkillers you may already be taking, for example paracetamol. This helps to manage your pain better.

Things to remember about opioids:

• Taking opioid medicines as your doctor advises helps to reduce the risk of addiction.
• Being prescribed an opioid does not always mean you are nearing the end of life. These medicines are used for many types of pain.
• If your pain gets worse over time, your doctor can adjust your medicine or add others to help you feel more comfortable.

Codeine

Codeine comes in different strengths. You may have taken it before – low doses are available without a prescription.

It works well when taken with paracetamol. This is why they are sometimes combined into one tablet called co-codamol.

Important: If you are taking co-codamol, do not take extra paracetamol.

You can take codeine up to four times a day, as instructed.

Tramadol

Tramadol can work better than codeine for some people. Your doctor or nurse may prescribe it if they think it will be more helpful for your pain.

It is usually prescribed as 50mg capsules. You can take one or two capsules, up to four times a day. Always follow the instructions from your doctor or nurse.

• Opioids often cause constipation. To help with this, drink plenty of water and eat foods high in fibre like fruit and vegetables. If needed, your doctor or nurse may recommend a laxative.
• Opioids can also make you feel drowsy or sleepy, especially when you first start taking them. This usually improves after a few days. If you still feel drowsy after that, let your doctor or nurse know. You might be taking the medicine too often or the dose may be too high.

Important: Do not drive, use machinery, or do anything that needs you to be fully alert if you feel drowsy.

• Some people feel sick or nauseous, especially in the beginning. This often settles after a few days. If it doesn’t, your doctor or nurse may prescribe you anti-sickness medicine to help relieve this.

Important: Alcohol can make you more drowsy when you are taking opioid medicines. We do not usually recommend it. Talk to your doctor or nurse if you drink alcohol while using opioid pain relief.

If you have any questions about your pain relief, or if it’s not helping with your pain, talk to your doctor, nurse, or the Enhanced Supportive Care team. They are there to help you feel as comfortable as possible.

UCLH Macmillan Support and Information Service
Tel: 020 3447 8663 
Email: uclh.supportandinformation@nhs.net

Macmillan Cancer Support
Tel: 0808 808 00 00

University College London Hospitals NHS Foundation Trust cannot accept responsibility for information provided by external organisations.

Enhanced Supportive Care team
Tel: 020 3447 3412
Email: uclh.esc1@nhs.net