Diamorphine for pain relief

About diamorphine

Strong opioids (sometimes called opiates) are medicines used to treat severe pain. Diamorphine is a type of strong opioid. It is used in particular to treat pain after a surgical operation and pain caused by cancer. It may also be used following a heart attack, or for breathlessness caused by fluid in the lungs. It works on your nervous system and brain to reduce the amount of pain you feel.

Diamorphine is usually given as an injection. Tablets of diamorphine are available but rarely prescribed. This is because other strong opioids (such as morphine) are preferred as they are absorbed better by your body when taken by mouth.

A nasal spray is available to treat severe pain in children. It is only given by a doctor or nurse in an emergency in hospital. A nasal spray is used because it is quicker to set up and less distressing for the child than an injection.

Before having diamorphine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons it is important that your doctor knows:

• Wenn Sie schwanger sind, ein Kind erwarten oder stillen.

• If you have heart, liver, or kidney problems.

• Wenn Sie Prostataprobleme oder Schwierigkeiten beim Wasserlassen haben.

• Wenn Sie Atemprobleme haben, wie z. B. Asthma oder chronisch obstruktive Lungenerkrankung (COPD).

• Wenn Ihnen gesagt wurde, dass Sie einen niedrigen Blutdruck (Hypotonie) haben.

• Wenn Sie Probleme mit Ihrer Schilddrüse oder den Nebennieren haben.

• Wenn Sie Epilepsie haben.

• Wenn Sie ein Problem mit Ihrem Gallengang haben.

• If you have severe diarrhoea, or have been constipated for more than a week, or have an inflammatory bowel problem.

• Wenn Sie an einer Muskelschwäche leiden, die Myasthenia gravis genannt wird.

• Wenn Sie kürzlich eine schwere Kopfverletzung erlitten haben.

• Wenn Sie jemals ein psychisches Problem namens Psychose hatten.

• Wenn Sie jemals von Drogen oder Alkohol abhängig waren.

• Wenn Sie schon einmal eine allergische Reaktion auf ein Arzneimittel hatten.

• Wenn Sie andere Arzneimittel einnehmen. Dazu gehören alle Arzneimittel, die Sie einnehmen und die rezeptfrei erhältlich sind, sowie pflanzliche und ergänzende Arzneimittel.

How diamorphine is given

• Diamorphine is given as an injection into a muscle or into your bloodstream. Your nurse or doctor will usually administer it for you. You may be given a repeat injection every four hours in order to control your pain.

• Diamorphine can also be given as an injection under the surface of your skin. Often this is done using a device known as a 'syringe driver' and a needle that stays attached to your skin. A syringe driver allows you to give yourself a dose of diamorphine without a nurse needing to inject it for you. This means that you can control your own pain relief by having a dose as soon as you feel it is needed. A syringe driver will only allow a certain number of doses to be given over a 24-hour period.

• If your child is in hospital and in severe pain, the doctor may decide to use a diamorphine nasal spray. The spray gives effective pain relief and is often suitable for emergency situations. The number of sprays used will depend on the weight of your child.

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• Ask to read the manufacturer's printed information leaflet for the product you (or your child) have been given - this will give you more information about diamorphine and a full list of the side-effects which you may experience from having it.

• Ask your doctor for advice before drinking alcohol. Your doctor may recommend you do not drink alcohol while you are on diamorphine because it increases the chance of side-effects such as feeling dizzy and sleepy.

• If you are a driver, please be aware that diamorphine is likely to affect your reactions and ability to drive. It is an offence to drive while your reactions are impaired. Even if your driving ability is not impaired, should you drive, you are advised to carry with you some evidence that the medicine has been prescribed for you - a repeat prescription form or a patient information leaflet from the pack is generally considered suitable.

• If you are planning a trip abroad and need to take a supply with you, you are advised to carry a letter from your doctor to explain that you have been prescribed diamorphine. This is because diamorphine is classed as a 'controlled drug' and is subject to certain restrictions.

• If you take or buy any 'over-the-counter' medicines, check with a pharmacist that they are suitable for you to take with diamorphine. Many other medicines have similar side-effects to diamorphine and taking them together will increase the risk of unwanted effects.

• Before having any other medical treatment, tell the person carrying out the treatment that you are having diamorphine as a painkiller.

• You will not be prescribed diamorphine for longer than necessary. This is because having diamorphine regularly for a long time can lead to your body becoming dependent on it, which might cause you to feel restless and irritable when it is then stopped. If you are concerned about this, discuss it with your doctor or pharmacist.

Can diamorphine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with diamorphine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Wenn Sie andere Symptome haben, von denen Sie glauben, dass sie auf dieses Arzneimittel zurückzuführen sind, sprechen Sie mit Ihrem Arzt oder Apotheker.

If you are caring for someone who has recently been given a dose of diamorphine and you notice the following side-effects, alert a doctor or nurse as soon as possible:

• Very small, 'pinpoint' pupils (the black circle of the eye).

• Shallow breathing or difficulty breathing.

• Losing consciousness (falling asleep).

• Having a fit (seizures or convulsions).
  

How to store diamorphine

• Bewahren Sie alle Arzneimittel außerhalb der Reichweite und Sichtweite von Kindern auf.

• An einem kühlen, trockenen Ort aufbewahren, vor direkter Hitze und Licht schützen.

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