Opioids for Breakthrough Pain

What are short-acting opioids?

Short-acting opioids, sometimes called breakthrough pain medications, are medicines that you take as needed when you feel pain. They are absorbed quickly into your body, providing relief in that moment. Although they work quickly, they wear off in about 3-4 hours. Examples are oxycodone, morphine, and hydromorphone (Dilaudid). Go to your Medicine Cabinet to see your short-acting opioid.

When to expect relief

It usually takes about 15-30 minutes to start feeling better, and 1 ½ hours to get the most relief.

How long they last

Short-acting opioids wear off in about 3-4 hours. So don’t be surprised if you feel your pain creeping back, and need to take another dose.

How to use short-acting opioids

Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take.

For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.

Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.

Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed.

If your pain is severe, start with the higher dose (for example: 2 tablets).
If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.