Pain Medications

From Anthony Nolan Medical Guidelines
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Explanation of Condition

Due to the nature of the medications used in pain management, almost all drugs CAN NOT be stopped without weaning if they require a prescription and can not be bought over the counter. Donors should never be encouraged to stop medication to donate. Decisions by donors to sop medications without consulting their physicians responsible for their condition should be actively discouraged.

Guidance

Non-steroidal Anti-inflammatory Drugs

Active substance

Ibuprofen, diclofenac, naproxen

Implications for donation

Increases the risk of bleeding and bruising

Recommendation

Fine if topical use. Find out which condition it is used for and if the condition is not a contraindication to donate. Need to stop tablets 24-48 pre-donation and similarly post donation if can tolerate not taking the medications or can use non NSAID alternative like paracetamol or co-codamol.

Over the counter medications, non-NSAIDs

Active substance

Paracetamol, co-codamol

Implications for donation

Minimal

Recommendation

Can donate provided the condition it is used for and is not a contraindication to donate

Opioid based medications (weaker)

Active substance

Codeine, dihydrocodeine, Tramadol

Implications for donation

No over the counter options to increase pain management.

Recommendation

If taking these medications regularly long term, there are no options for pain management with over the counter medications but options available to increase the pain management with prescription medications/hospital admission. Discuss with MO as in some circumstances might be appropriate to donate.

Opioid based medications (strong)

Active substance

Morphine ( MST, Zomorph, Sevredol, Morphgesic, MXL, Oramorph), oxycodone (OxyContin, Xtampza ER, Roxicodone, Percocet, Percodan), fentanyl, buprenorphine, diamorphine

Implications for donation

No over the counter options to increase pain management. Usually suggest significantly painful condition. High doses of opioids can sedate people.

Recommendation

If taking these medications regularly long term, there is no over the counter options for pain management and limited options even with hospital admission, and, therefore, donor should not donate.

If taken short term, donor needs to be off the medication before proceeding.


Anti-convulsant medications used in pain management

Active substance

Pregabalin, gabapentin

Implications for donation

Can be sedative, suggests complex pain condition

Recommendation

Discuss with MO, although the medications are not contraindications on their own, condition for which patient is taking the medication can be a contraindication. Limited options for pain management escalation.