Case presentation

An 82-year-old woman with metastatic ovarian cancer is being discharged home for end-of-life care. She is currently comfortable and able to swallow. The hospital palliative team asks you to prescribe an anticipatory ('just in case') subcutaneous analgesic for the community team. She is on oral morphine (30 mg oral morphine equivalent per 24h). Her eGFR is 24 mL/min/1.73m2. She has no allergies.

Observations / investigations

Task

Select the single most appropriate anticipatory subcutaneous opioid to prescribe given her renal function.