Drowsiness: inability to hold conversation, read or concentrate because of sleepiness.

Patient may or may not have co-existent tiredness.

Manage drowsiness because it may reduce quality of life.


Manage opioid side effects

  • common side effect with starting/increasing dose; should clear within 48-72 hours
  • if drowsiness persists and pain is controlled, reduce opioid
  • if drowsiness persists and pain is not controlled, rotate opioid
  • if unable to reduce or rotate opioid, consider stimulant

Talk tip: when prescribing any opioid, warn patient to expect drowsiness in the first 2-3 days.


  • 5-10mg po in the a.m. and noon
  • frail older adult: 2.5-5mg po in a.m. and noon

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