Opioid information sheet

Opioids come in different formulations such as liquid, syrups, tablets, capsules, lozenges, patches (applied to your child’s skin) and injections. 

Our team will discuss which opioid and formulation is best for your child.

Opioids may be given to provide long acting symptom relief. These are known as a “background” dosing regimen. A “background” dosing regimen may be given as oral/enteral doses, a patch on the skin or as a continuous infusion (either intravenous or under the skin). 

Additional doses can be used if required. These are often called “breakthrough” doses. These are usually given as liquids, syrups, tablets, capsules, lozenges or injections (either intravenous or under the skin).
 

The dose needed is very individual and depends on the specific symptoms your child has. Some children need more than others. 

• The correct dose is the amount that eases your child's pain. 
• Your doctor will work out a safe starting dose, which may need to be increased or decreased.
• The dose may need to be increased or decreased so that your child achieves the best possible symptom control, with the least side effects.
• We will carefully monitor your child for any changes. 

There is no maximum dose of opioids, however if your child continues to need increased doses, they may not be on the right opioid for them and we may consider changing to a different opioid.

Your child's body may get used to a certain dose of opioid and the dose may need to be increased over time. This is called 'tolerance'. A dose increase does not necessarily mean your child's condition is getting worse and does not mean that they are becoming addicted.
 

Levomepromazine may cause the following unwanted side effects:

• constipation
• nausea and vomiting
• drowsiness
• itch
   

Not everybody experiences side effects and it is important to remember these are not an allergic reaction, and are often temporary and manageable. 

If your child experiences any of these unwanted side effects, please inform us.

If your child does not tolerate one opioid, this does not mean they will have the same side effects with a different opioid.

If your child stops taking opioids suddenly this may cause them to become unwell. Please speak to your doctor if you have any concerns.

 

Opioids will mask the symptoms and signs of my child’s illness

• Pain medicines will not stop your child’s health care team or you from monitoring the progress of your child’s illness. There are other signs and symptoms of progression that can be observed.

I should wait until my child’s pain is worse before giving opioids

• Pain is better controlled when managed early. Your child’s pain may be more difficult to control if left too long without treatment.

Opioids medicines are addictive

• Opioids are not addictive when given appropriately (i.e. at a safe dose and for the right reasons). Opioids may be addictive when used for incorrect purposes.

Opioids will slow down my child’s breathing

• When opioids are used safely and appropriately, they do not have a significant effect on breathing.

Opioids will shorten my child’s life

• Relieving your child’s pain changes their quality of life, but will not shorten its length.
   

To ensure safe use of this medication, please:

• be familiar with your child’s medicine including the name, brand, strength and dose. It is a good idea to have this information written down 
• store your child’s medicine in a safe place, out of reach of children, pets and vulnerable people. Ensure it is out of direct sunlight and not near heat sources like heaters  
• measure your child’s doses carefully and accurately 
• know how to give your child’s medicine, for example, know if a tablet can be crushed, or if a liquid can be mixed with another substance 
• give your child’s medicines at times prescribed. Setting up reminders may help  
• record when you have given medicines to your child 
• record the effects of medicines, especially any side effects or unusual reactions, and tell your child’s doctor 
• know what to do if you forget to give your child a dose, for example, whether you give it when you remember or wait until the next scheduled dose? NB. Never double a dose to make up for a missed dose 
• do not intentionally miss or change your child’s medicines without telling your doctor
  ensure you always have adequate supply of medicines so you never run out, particularly over weekends or public holidays
• return any unused, unwanted or expired medicines to any pharmacy for appropriate disposal. Do not put medicines in the bin or down the drain.