Patient Information Leaflet

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The links below will direct you to medicines.ie , an external website providing information about medicines in Ireland, including the Patient Information Leaflet (PIL) and the Summary of Product Characteristics (SPC).

The product information provided in this site is intended for residents of Ireland only. The following documents are hosted externally. Grünenthal Pharma Ltd. is not responsible for the content of external sites.

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General considerations for the management of pain with any medication that contains an opioid mechanism of action

The following general aspects should be considered

  • An individualised, patient-centered approach for the diagnosis and treatment of pain is essential to establish a therapeutic alliance between patient and clinician.
  • Consider patient variables that may affect opioid dose for each patient prior to opioid use1
  • In patients with acute pain e.g. post-surgery pain, the use of medication should be for the shortest necessary time1
  • All patients should be carefully selected, abuse risk factors evaluated and regular monitoring and follow-up implemented to ensure that opioids are used appropriately3,4 and in alignment with treatment goals (pain intensity and functionality) as agreed with the patient3,4
  • Patients should be made aware of the potential side effects of opioids and the potential for developing tolerance, dependence and addiction3,4
  • It is important to optimally use multimodal, non-opioid approaches in acute and chronic pain before escalating to opioids or in conjunction with opioid therapy1
  • Addiction is possible even when opioids are taken as directed. The exact prevalence of abuse in patients treated with opioids for chronic pain is difficult to determine5
  • Regular clinical reviews are required for long-term opioid treatment to assess pain control, impact on lifestyle, physical and psychological well-being, side effects and continued need for treatment2
  • Any long term treatment with opioids should be monitored and re-evaluated regular including tapering down the dose or discontinuing treatment3,4
  • Signs of opioid use disorder should be monitored and addressed3,4
  • Patients and the general public can benefit from clear educational materials and awareness interventions to support the responsible use of opioids6

 

1. DHHS Pain Management Best Practices Inter-Agency Taskforce Report May 2019
2. O’Brien T et al. Eur J Pain 2017;21:3-192
3. Faculty of Pain Medicine, Opioids Aware https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware Accessed September 2019
4. Kosten TR et al, Scie Pract. Perspect 2002;1:13-20
5. Rosenblum A et al Exp. Clin. Psychopharmacol. 2008;16(5):405-416
6. OECD Health Policy. Addressing Problematic opioid use in OECD Countries May 2019 http://www.oecd.org/health/addressing-problematic-opioid-use-in-oecd-countries-a18286f0-en.htm

 

M-ALL-IE-03-20-0001 – March 2020