Diamorphine for pain relief

About diamorphine

Diamorphine is a strong opioid painkiller 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 available as:

• An injection.

• Nasal spray.

• Tablets.

Diamorphine is usually given by injection. Tablets are rarely prescribed because other strong opioids, such as morphine, are absorbed better when taken by mouth.

For children with severe pain, diamorphine may be given as a nasal spray in hospital emergencies. This is quicker and less distressing than an injection.

Common side effects of diamorphine are:

• Feeling drowsy or sleepy.

• Feeling dizzy.

• Feeling sick.

• Being sick (vomiting).

• Constipation.

• Dry mouth.

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 side effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

Some medicines are not suitable for people with certain conditions. Before taking diamorphine it is important that your doctor knows:

• If you are pregnant, trying for a baby, or breastfeeding.

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

• If you have prostate problems or any difficulties passing urine.

• If you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).

• If you have been told you have low blood pressure (hypotension).

• If you have any problems with your thyroid or adrenal glands.

• If you have epilepsy.

• If you have a problem with your bile duct.

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

• If you have a condition causing muscle weakness, called myasthenia gravis.

• If you have recently had a severe head injury.

• If you have ever had a mental health problem called psychosis.

• If you have ever been dependent on drugs or alcohol.

• If you have ever had an allergic reaction to a medicine.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.

• Diamorphine is usually given as an injection into a muscle or directly into a vein. A doctor or nurse will give the injection, and it may be repeated every four hours to control pain.

• Diamorphine can also be given as an injection just under the skin, often using a syringe driver.

• A syringe driver is a small device that delivers controlled doses through a needle that stays in place. This allows pain relief to be given when needed, without repeated injections. The device limits how much diamorphine can be given over 24 hours.

• In hospital, children with severe pain may be given diamorphine as a nasal spray. This provides fast pain relief and is often used in emergencies. The dose depends on the child’s weight.

• Read the patient information leaflet that comes with the medicine. It explains how diamorphine works and lists possible side effects.

• Ask your doctor about alcohol. You may be advised not to drink alcohol while taking diamorphine, as it can increase side effects such as dizziness and drowsiness.

• Driving may be affected. Diamorphine can slow your reactions and make driving unsafe. It is illegal to drive if your ability is impaired. If you do drive, carry proof that the medicine has been prescribed for you.

• If you are travelling abroad and need to take diamorphine with you, carry a letter from your doctor. Diamorphine is a controlled drug and is subject to legal restrictions in many countries.

• Check other medicines first. Some over-the-counter medicines can increase side effects when taken with diamorphine. Ask a pharmacist before taking any new medicine.

• Tell healthcare professionals that you are taking diamorphine before having any other treatment.

• Diamorphine is used for short periods only. Long-term use can lead to dependence and withdrawal symptoms such as restlessness or irritability. Speak to your doctor or pharmacist if you are concerned.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

How long does it take for diamorphine to work?

Diamorphine usually starts to work in 15-20 minutes when injected into a muscle, such as your thigh or bottom, and lasts for 2-4 hours.

Is it safe to have diamorphine during pregnancy?

Diamorphine is usually only used early in pregnancy. Using it for a long time can cause the baby to become dependent and have withdrawal symptoms after birth. If taken close to delivery, it can also affect the baby’s breathing

What's the difference between diamorphine and morphine?

Diamorphine is a stronger and faster-acting form of morphine. Once in the body, diamorphine is converted into morphine, but it reaches the brain more quickly, providing faster pain relief.

Is diamorphine addictive?

Yes, diamorphine can be addictive, especially with regular or long-term use. It can cause dependence, meaning you may experience withdrawal symptoms if it is stopped suddenly.