![]() Use immediate-release preparations to find the dose that provides effectiveĪnalgesia with the most acceptable side effects, then switch to a sustained-release preparation to ensure stable, ‘round-the-clock’ analgesia. Oral morphine is generally the first choice when an opioid is required for severe chronic pain, because of its familiarity, availability and range of strengths and formulations that allow greater flexibility in dose titration. † and potential for extraction for illicit use. Gel-reservoir patches, which had problems with leaking A matrix ‘drug-in-adhesive’* formulation has replaced the previous ![]() Fentanyl accumulates to form a ‘depot’ in the skin below the patch, from where it gradually enters the circulation. ![]() The transdermal patch is a long-acting formulation with a delayed onset of effect initially and a prolonged duration of action plasma concentrations are halved about 17 hours after removal.
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