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