Sunday, September 22, 2013

WHO's Pain Ladder

WHO has provided a three-step "ladder" for pain relief in cancer patients. According the the WHO pain ladder, in the patients with cancer the pain is controlled by prompt oral administration of drugs in the following order: 

  • Non-opioids (aspirin and paracetamol) 

  • Mild opioids (codeine) 

  • Strong opioids such as morphine, until the patient is free of pain


To relieve anxiety, additional drugs called “adjuvants” are used.  To maintain control over the cancer pain, drugs should be used “by the clock”, that is every 3-6 hours, than to be given  on demand only. Three step ladder approach of administering of  the right drugs at right dose at the right time the most effective and inexpensive way of relieving pain.

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Keywords: WHO pain ladder, Cancer pain, Non-opioids, Mild opioids, Strong opioids

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