Amitriptyline*
50-150 mg tablets
Depression
Neuropathic pain
Bisacodyl
10 mg tablets
10 mg rectal suppositories
Constipation
Carbamazepine**
100-200 mg tablet
Neuropathic pain
Citalopram (or any other equivalent generic SSRI except paroxetine and fluvoxamine)
20 mg tablets
10 mg/5ml oral solution
20-40 mg injectable
Depression
Codeine
30 mg tablets
Diarrhea
Pain - mild to moderate
Dexamethasone
0.5-4 mg tablets
4 mg/ml injectable
Anorexia
Nausea
Neuropathic pain
Vomiting
Diazepam
2.5-10 mg tablets
5 mg/ml injectable
10 mg rectal suppository
Anxiety
Diclofenac
25-50 mg tablets- mg tablets
50 and 75 mg/3ml injectable
Pain mild to moderate
Diphenhydramine
25 mg tablets
50 mg/ml injectable
Nausea
Vomiting
Fentanyl (transdermal patch)
25 micrograms/hr
50 micrograms/hr
Pain - moderate to severe
Gabapentin
tablets 300 mg or 400 mg
Neuropathic pain
Haloperidol
0.5 - 5 mg tablets
0.5 - 5 mg drops
0.5 - 5 mg/ml injectable
Delirium
Nausea
Vomiting
Terminal restlessness
Hyoscine butylbromide
20 mg/1ml oral solution
10 mg tablets
10 mg/ml injectable
Nausea
Terminal respiratory congestion
Visceral pain
Vomiting
Ibuprofen
200 mg tablets
400 mg tablets
Pain - mild to moderate
Levomepromazine
5-50 mg tablets
25 mg/ml injectable
Delirium
Terminal restlessness
Loperamide
2 mg tablets
Diarrhea
Lorazepam***
0.5-2 mg tablets
2 mg/ml liquid/drops
2-4 mg/ml injectable
Anxiety
Insomnia
Megestrol Acetate
160 mg tablets
40 mg/ml solution
Anorexia
Methadone (immediate release)
5 mg tablets
1 mg/ml oral solution
Pain - moderate to severe
Metoclopramide
10 mg tablets
5 mg/ml injectable
Nausea
Vomiting
Midazolam
1-5 mg/ml injectable
Anxiety
Terminal restlessness
Mineral oil enema
Mirtazapine (or any other generic dual action NassA or SNRI)
15-30 mg tablets
7.5-15 mg injectable
Depression
Morphine
Immediate release: 10-60 mg tablets
Immediate release: 10mg/5ml oral solution
Immediate release: 10 mg/ml injectable
Sustained release: 10 mg tablets
Sustained release: 30 mg tablets
Dyspnea
Pain - moderate to severe
Octreotide
100 mcg/ml injectable
Diarrhea
Vomiting
Oral rehydration salts
Diarrhea
Oxycodone
5 mg tablet
Pain - moderate to severe
Paracetamol (Acetaminophen)
100-500 mg tablets
500 mg rectal suppositories
Pain - mild to moderate
Prednisolone (as an alt to Dexamethasone)
5 mg tablet
Anorexia
Senna
8.6 mg tablets
Constipation
Tramadol
50 mg immediate release tablets/capsules
100 mg/1ml oral solution
50 mg/ml injectable
Pain - mild to moderate
Trazodone
25-75 mg tablets
50 mg injectable
Insomnia
Zolpidem (still patented)
5-10 mg tablets
Insomnia
Complementary: Require special training and/or delivery method
* Side-effects limit dose
**Alternatives to amitriptyline and tricyclic antidepressants (should have at least one drug other than dexamethasone)
*** For short term use in insomnia
Notes:
Non Benzodiazepines should be used in the elderly
Non Steroidal Anti Inflamatory Medicines (NSAIMs) should be usef for brief periods of time
NO GOVERNMENT SHOULD APPROVE MODIFIED RELEASE MORPHINE, FENTANYL OR OXYCODONE WITHOUT ALSO GUARANTEEING WIDELY AVAILABLE NORMAL RELEASE ORAL MORPHINE.
This list is copyrighted by IAHPC. The organization provides permission for free reproduction, printing and publication of this list with appropriate citation and reference
Source:
IAHPC Essential Medicines for Palliative Care List
https://hospicecare.com/uploads/2011/8/iahpc-essential-meds-en.pdf
END OF LIFE PRESCRIBING GUIDANCE
