Opioids – no effect without side effects

Patches containing the highly effective opioid  fentanyl  are now standard therapy for chronic pain. However, how the patient tolerates and accepts the therapy largely depends on whether side effects are also treated. Nauseaconstipation ,  and dizziness are the most common side effects of opioids. Patients in particular who are being prescribed these active ingredients for the first time sometimes react sensitively: the body needs an adjustment phase. These side effects are normal and not dangerous, nor do they occur in every case. However, many patients react with uncertainty and anxiety if they were not sufficiently informed by the doctor treating them before starting therapy.

Nausea, constipation, dizziness

Nausea  occurs because opioids stimulate the vomiting center in the brain, not because the stomach is upset, as many patients fear If the active substances  metoclopramide  or domperidone are prescribed concomitantly and taken in good time, the urge to vomit does not occur in the first place. In many cases, the nausea disappears after an adjustment period of two to three weeks.

The reason for the  constipation  is the effect of opioids on the intestinal muscles, the activity of which is reduced. However, numerous studies have shown that the fentanyl patch offers advantages here: The active ingredient is not absorbed through the gastrointestinal tract as is the case with taking tablets. The influence on the intestinal muscles is therefore lower. If the constipation is still persistent, a  laxative must be  prescribed.

Dizziness  and  lightheadedness  occur because opioids act on the central nervous system. This side effect often disappears after just one or two days. If this does not happen or if the dizziness worsens, the doctor will reduce the dose or stop the drug.

benefits of therapy

Despite these symptoms that sometimes occur, therapy with opioids for severe chronic pain offers many advantages over simple painkillers such as  ibuprofen  or  diclofenac . Liver, kidney and stomach are not burdened and the effect is much higher. A life with normal everyday activities is often only possible again in this way. The widespread fear of dependence is unfounded when retarded, i.e. long-acting, drugs are given.

tips for handling

In order to make pain therapy with opioids as successful and tolerable as possible, those affected can also do a few things themselves:

  • Take opioids strictly as directed by your doctor.
  • Change your diet. Eating a high-fiber diet, drinking plenty of fluids, and getting enough exercise help prevent constipation.
  • If you get a pain patch, stick it on a hairless part of your body. It is best to clean the area beforehand with lukewarm water, but never with moisturizing washing lotions or disinfectant sprays. The patch will then not stick properly. Gently pat the area dry and press the patch firmly for 30 seconds.
  • Don’t overwhelm yourself at the beginning of therapy. Make sure you have a relaxed daily rhythm and do not expose yourself to any major stress in the first two weeks. If you suffer from side effects such as dizziness or nausea, you should never drive a car. After the recruitment phase, this is possible again if you dare and feel fit. Monitor any side effects, but don’t focus on them too much. Face dizziness with serenity: it is not a symptom of illness.
  • Ask your doctor if you are unsure.


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