The morphine rescue dose is the analgesic supplement to administer in case of breakthrough pain in cancer patients. It is indissociable from the background 24-hour opioid treatment. Guidelines for administering:

Prescribe an opioid:

1. With an estimated analgesic strength of between 10 to 15 % of the background 24-hour opioid treatment

2. When step III opioid background treatment starts

3. Using a fast-acting opioid

Inform the patient of the following:

1. ‘On demand’ administration when breakthrough pain occurs

2. There is a minimum of 4 hours between two rescue doses

3. The rescue dose can be given as a preventative measure in case of painful actions (administration of care or transport)

4. It is important to keep track of the rescue doses administered in a logbook

5. Background pain relief treatment is continued

Monitor:

1. The proper progress of the treatment and the logging of the rescue doses

2. Individual tolerance and the appearance of signs of morphine overdose

3. Envisage an increase in the background analgesia once 3 rescue doses are administered per 24 hours