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Grünenthal’s charter on the responsible medical use of opioids and overview of medication that contains an opioid mechanism of action

*General considerations for the management of pain with any medication that contains an opioid mechanism of action

The following general aspects should be considered

  • An individualized, patient-centered approach for the diagnosis and treatment of pain is essential to establish a therapeutic alliance between patient and clinician.
  • Consider patient variables that may affect opioid dose for each patient prior to opioid use (1)
  • In patients with acute pain e.g. post-surgery pain, the use of medication should be for the shortest necessary time (1)
    All patients should be carefully selected, abuse risk factors evaluated and regular monitoring and follow-up implemented to ensure that opioids are used appropriately (3-4) and in alignment with treatment goals (pain intensity and functionality) as agreed with the patient (3-4)
  • Patients should be made aware of the potential side effects of opioids and the potential for developing tolerance, dependence and addiction (3-4).
  • It is important to optimally use multimodal, non-opioid approaches in acute and chronic pain before escalating to opioids or in conjunction with opioid therapy (1)
  • Addiction is possible even when opioids are taken as directed. The exact prevalence of abuse in patients treated with opioids for chronic pain is difficult to determine (5)
  • Regular clinical reviews are required for long-term opioid treatment to assess pain control, impact on lifestyle, physical and psychological well-being, side effects and continued need for treatment (2)
  • Any long term treatment with opioids should be monitored and re-evaluated regular incl. tapering down the dose or discontinuing treatment (3-4)
  • Signs of opioid use disorder should be monitored and addressed (3-4)
  • Patients and the general public can benefit from clear educational materials and awareness interventions to support the responsible use of opioids (6)

M-N/A-HQ-02-20-0012

1. DHHS Pain Management Best Practices Inter-Agency Taskforce Report May 2019
2. O’Brien T et al. Eur J Pain 2017;21:3-192
3. Faculty of Pain Medicine, Opioids Aware https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-aware Accessed September 2019
4. Kosten TR et al, Scie Pract. Perspect 2002;1:13-20
5. Rosenblum A et al Exp. Clin. Psychopharmacol. 2008;16(5):405-416
6. OECD Health Policy. Addressing Problematic opioid use in OECD Countries May 2019 http://www.oecd.org/health/addressing-problematic-opioid-use-in-oecd-countries-a18286f0-en.htm

Opioid Disclaimer

For Grünenthal’s charter on the responsible medical use of opioids, please open the following document.

Overview of medication that contains an opioid mechanism of action

  • Product list
    Active ingredient / Technology  Brand name, examples  Indication range,
    EU as example1
     Tapentadol Palexia™* 
     
    Film-coated tablet:
    Relief of moderate to severe acute pain which can be adequately managed only with opioid analgesics

    Oral solution:
    Relief of moderate to severe acute pain in children from 2 years of age2 and in adults which can be adequately managed only with opioid analgesics

    Prolonged-release tablet:
    Management of severe chronic pain which can be adequately managed only with opioid analgesics
     Tramadol  Tramal™*  Treatment of moderate to severe pain
    Fixed-dose combination of Tramadol and Paracetamol  Zaldiar™* Symptomatic treatment of moderate to severe pain; use should be restricted to patients whose moderate to severe pain is considered to require a combination of tramadol and paracetamol
     Buprenorphine  Transtec™* Moderate to severe cancer pain and severe pain which does not respond to non-opioid analgesics; not for use in acute pain

     

    1 Status: March 2019. 
    2 Restricted to hospital use where appropriate equipment to enable respiratory support is available and for a maximum treatment duration of 3 days.