Pharmacological management of symptoms for adults in the last days of life

All patients at the end of life are entitled to treatment to optimise their comfort and dignity. The treating team responsible for the care of a dying patient works together with the patient and their nominated carers/family members to ensure appropriate, timely and adequate treatment to prevent and relieve distress. This will often include prescribing medications for symptom management.

Anticipatory prescribing

There are several common symptoms that may cause distress in dying patients. Ordering medications ahead of time, 'anticipatory prescribing', is required so that prompt management of these symptoms can occur.

SA Health Prescribing guidelines for the pharmacological management of symptoms for adults in the last days of life (PDF 154KB) can be used in:

  • response to a patient suffering from distressing symptoms, and/or
  • anticipation of distressing symptoms developing.

See also the Pharmacological Management of Symptoms for Adults in the Last Days of Life Clinical Guideline (PDF 632KB)

Opioid dose conversions

Principles enquiry

Therapeutic Guidelines: Palliative Care
Changing from one opioid to another - page 217
Access available through SALUS

Switch between opioid formulations

eviQ: Cancer Treatments Online
Opioid conversion calculator - available online only
Access is open and registration is free

Therapeutic Guidelines: Palliative Care
Approximate potencies of various opioids relative to 10mg parenteral morphine - table 1.8
Access available through SALUS

Australian Medicines Handbook (AMH)
Opioid comparative information - page 48
Access available through SALUS

Medication cessation

The Medication cessation for adults in the last days of life fact sheet (PDF 154KB) assists clinicians when considering which medications may be discontinued at the end of life and the potential withdrawal effects.

Decision Assist is a web-based resource funded by the Australian Government to enhance the provision of palliative care and advance care planning. Resources available include: