Patches containing the highly effective opioid fentanyl are now part of the standard therapy for chronic pain. However, how the patient tolerates and accepts the therapy depends largely on whether side effects are co-treated. Nausea, constipation and dizziness are the most common side effects of opioids. Patients who are prescribed these agents for the first time sometimes react sensitively: the body needs an adjustment phase. These side effects are normal and not dangerous; they also do not occur in every case. However, many patients react in an unsettled and anxious manner if they have not been adequately informed by the treating physician before starting the therapy.
Nausea, constipation, dizziness.
Nausea occurs because opioids irritate the vomiting center in the brain, not because the stomach is stressed, as many patients fear. If the agents metoclopramide or domperidone are prescribed concomitantly and taken in a timely manner, nausea does not occur in the first place. In many cases, the nausea disappears after an adjustment phase of two to three weeks.
The reason for the constipation is the effect of opioids on the intestinal muscles, whose activity 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 when taking tablets. The effect on the intestinal muscles is therefore less. If constipation is nevertheless persistent, a laxative must be prescribed.
Dizziness and lightheadedness occur because opioids act in the central nervous system. This side effect also often disappears after one or two days. If this does not happen or if the dizziness worsens, the doctor will reduce the dose or stop the medication.
Painkillers: which one, when and for what?
Advantages of therapy
Despite these symptoms that sometimes occur, opioid therapy for severe chronic pain offers many advantages over simple pain relievers such as ibuprofen or diclofenac. The liver, kidney, and stomach are not stressed, and the effect is incomparably greater. A life with normal everyday activities often only becomes possible again. The widespread fear of dependence is unfounded when slow-release, i.e. long-acting, agents are given.
Tips for handling
To make pain therapy with opioids as successful and tolerable as possible, sufferers can also do a few things themselves:
- Take opioids strictly as directed by your doctor.
- Change your diet. High-fiber diet, plenty of fluids and sufficient exercise help against constipation.
- If you get a pain patch, stick it on a hairless part of the body. It is best to clean the area beforehand with lukewarm water, but in no case with re-lubricating washing lotions or disinfectant sprays. The patch will then not stick properly. Dab the spot dry carefully and press the patch firmly for 30 seconds.
- Do not overexert yourself at the beginning of therapy. Make sure you have a relaxed daily rhythm and do not expose yourself to major stress during the first two weeks. If you suffer from side effects such as dizziness or nausea, you should not drive under any circumstances. After the adjustment phase, this is possible again if you feel confident and fit. Observe any side effects, but do not focus too much on them. Meet dizziness with composure: they are not a symptom of the disease.
- Ask your doctor if you are unsure.
