Treatment of adverse effects of chronic opioid use

Y45.0

Constipation:

Patients on chronic opioids should routinely be prescribed a laxative.

• Sennosides A and B, oral, 13.5 mg, 1–2 tablets at night.
  • Contraindicated in patients with potentially obstructive lesions.

LoEIII [7]

In patients with potentially obstructive lesions:

• Lactulose, oral, 10–20 mL 12 hourly.

LoEIII [8]

Nausea and vomiting:

• Metoclopramide, oral/IM/slow IV, 10 mg 8 hourly See Postoperative nausea and vomiting (PONV).

OR

• Promethazine, oral, 10 mg 8 hourly.

LoEIII

OR

• Ondansetron, oral, 8 mg 12 hourly.