Diamorphine

Diamorphine is a pain killing drug. It is a type of opioid.

You can only get diamorphine on prescription from your doctor. It is similar to the drug morphine. You have diamorphine for moderate to severe pain. Opioids work by acting like the body’s natural painkillers known as endorphins. They control pain by blocking pain messages to the brain. You can find out more about cancer and pain control in our coping physically section.

The dose of diamorphine you have depends on the level of pain that you have and the amount you need to control your pain. Your doctor or nurse will give you instructions on how much diamorphine to have and when to have it.

Because diamorphine is an opioid, some people worry about becoming addicted to it. When you take an opioid to control pain, it is very unlikely that you will become addicted. The body uses the drug to control pain, not to give you a ‘high’. You can read more information about fear of addiction in our treating pain section.

If you become drowsy after having diamorphine for a while, it may mean you need to lower your dose. Talk to your doctor or nurse before you change your dose. It is important to let your doctor or nurse know. It can be very harmful to just stop taking diamorphine. You are likely to need to slowly reduce the amount you take.

You have diamorphine as an injection. This may be into your

• Fatty tissue (subcutaneously) as an injection or through a small needle connected to a pump
• Vein (intravenously)
• Muscle (intramuscularly) – but this is not common

You may have diamorphine through a pump called a syringe driver. This delivers liquid from a syringe to a needle put just under the skin (subcutaneously). The pump gives you a small amount of diamorphine continuously. A nurse changes the pump every 24 to 48 hours. Or they will teach you or your carer how to do this.

More than 10 in every 100 people have one or more of these.

• Constipation – drink plenty of water and eat fibre rich foods. Your doctor or specialist nurse will give you laxatives to help prevent constipation but let them know if you are constipated for more than 3 days
• Feeling or being sick is usually well controlled with anti sickness drugs
• Drowsiness may be a problem at first, or when your dose is increased, but this usually wears off after a few days
• Sweating

Between 1 and 10 in every 100 people have one or more of these.

• A dry mouth – this affects most people
• Dizziness
• Headaches
• Mood changes – you may feel very happy or feel very sad or depressed
• Confusion
• Narrowing of the pupils in your eyes
• Lowered sex drive (libido)
• Griping pain in your stomach – if you have pain and haven’t opened your bowels tell your doctor or nurse

Fewer than 1 in 100 people have these.

• A skin rash
• Difficulty passing urine
• Slowing of the heart beat or palpitations – tell your doctor or nurse as you may need a lower dose of diamorphine
• Drop in blood pressure
• Slowed breathing – tell your doctor or nurse as you may need a lower dose

The side effects above may be mild or more severe. A side effect may get better or worse, or more side effects may develop while you are having diamorphine. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other treatments you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. You should have a contact number for your specialist nurse, clinic or ward. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.