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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Severe Pain Due To Colon Cancer Inspite Of Taking Oxycodone?

Hi my sister just turned 40 in April 2015 however she was diagnosed with stage 3 colon cancer has been in severe pain ever since is now a stage 4 because it has spread to her liver they have prescribed oxycodone and percocet but it does not I repeat does not work at all for pain it just makes her sick... She has an doctors app this week with GWR doctor to talk about other options so what would be some drugs to mention... And codeine and Tylenol don t work at all and she is not allowed to take any ibuprofen like motrin at all what so ever by her doctors... Any ideas we are desperate
Mon, 14 Sep 2020
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General & Family Physician,  's  Response
Hi,

Morphine is considered the standard opiate and the drug of choice in the treatment of moderate to severe cancer pain. According to the WHO's treatment protocol of pain management in patients with cancer, as your patient has treated before with opioids like oxycodone, codeine etc, so opiate like morphine will be the next step for her pain management. A sustained release (SR) preparation of morphine can be given every 8-12 hours with breakthrough doses of immediate release (IR) form given every 3-4 hours in between if needed. Nausea, vomiting, constipation, dependency may arise as the side effects of morphine use. For that, antiemetics, laxatives etc may be needed.

If morphine fails to subside the pain, another opiate should be introduced and dosed according to its morphine equivalency. Hydromophone is the next treatment of choice which is more potent than morphine allowing for smaller doses to be used.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Zubayer Alam, General and Family Physician,
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How To Treat Severe Pain Due To Colon Cancer Inspite Of Taking Oxycodone?

Hi, Morphine is considered the standard opiate and the drug of choice in the treatment of moderate to severe cancer pain. According to the WHO s treatment protocol of pain management in patients with cancer, as your patient has treated before with opioids like oxycodone, codeine etc, so opiate like morphine will be the next step for her pain management. A sustained release (SR) preparation of morphine can be given every 8-12 hours with breakthrough doses of immediate release (IR) form given every 3-4 hours in between if needed. Nausea, vomiting, constipation, dependency may arise as the side effects of morphine use. For that, antiemetics, laxatives etc may be needed. If morphine fails to subside the pain, another opiate should be introduced and dosed according to its morphine equivalency. Hydromophone is the next treatment of choice which is more potent than morphine allowing for smaller doses to be used. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Zubayer Alam, General and Family Physician,