Description
In the management of cancer pain, morphine remains the most widely prescribed opioid analgesic. In clinical practice, increasing doses of strong opioid (usually morphine) are titrated against pain until analgesia is achieved. In a minority of cases analgesia is inadequate or unmanageable side-effects intervene. In this situation it is often useful to change to an alternative strong opioid and the term “opioid rotation” has been introduced to describe this. The aim of this review is to examine the published experience of opioid rotation, to consider some of the theoretical underlying mechanisms and to highlight areas for future research.
