4. Principal risks and risk-reduction measures
Some noteworthy risks of opioids are discussed in this module. Summaries of product characteristics and the BNF should be consulted for a fuller account of the adverse effects and warnings for individual opioids.
Note. Some advice in this module may not apply in the palliative care setting. Also, the module does not cover infrequent effects which occur on chronic treatment, such as hyperalgesia, myoclonus, and endocrine derangement.
Very common (> 10%) and common (1–10%) adverse effects:
- Gastrointestinal adverse effects—nausea, vomiting, constipation, abdominal pain, dry mouth
- Central nervous system and psychiatric effects—headache, drowsiness, sedation and sleep disturbances, dizziness, confusion, dysphoria
- Cardiovascular adverse effects—hypotension and bradycardia
- Respiratory adverse effects—aggravation of bronchospasm
- Effects on the skin—pruritus, rash, flushing, sweating
- Other adverse effects—urinary retention, miosis
Infrequent but potentially serious adverse effects:
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