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Review
. 2025 Jul;25(4):100330.
doi: 10.1016/j.clinme.2025.100330. Epub 2025 May 27.

Opioid analgesics: Managing the predictable

A Barnes  1 , G Heppenstall-Harris  2 , A Dickman  3
Affiliations
Review

Opioid analgesics: Managing the predictable

A Barnes et al. Clin Med (Lond). 2025 Jul.

Abstract

It is imperative for clinicians to understand the common adverse effects of opioid therapy and ensure patients are properly counselled on them prior to opioid initiation. Predictable adverse effects are wide ranging, and include bowel dysfunction, nausea, sedation, endocrinopathy and pruritis. Many adverse effects (with the notable exception of constipation) improve with time; however, patients should undergo regular re-assessment to identify new or evolving symptoms. Opioid rotation can also be a useful therapeutic tool to mitigate intolerable opioid adverse effects. This article aims to provide a succinct review of important adverse effects and effective management techniques to enhance patient outcomes and quality of life.

Keywords: Analgesia; Constipation; Dependence; Endocrinopathy; Morphine; Nausea; Opioids; Pruritis; Sedation.

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Conflict of interest statement

Declaration of competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Andrew Dickman reports a relationship with Sandoz Inc that includes: consulting or advisory and speaking and lecture fees. Andrew Dickman reports a relationship with Kyowa Kirin Inc that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Opioid analgesics: Managing the predictable
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