Work

Comprehensive Analysis of Strong Opioid Side Effects in Palliative Care Using the SIDER Database

Year: 2025

Type: article

Abstract: Background/Objectives: Opioid-based treatments in palliative care involve multiple options, each with distinct side effect profiles. When adverse effects occur, switching opioids can help maintain effective pain management. However, owing to limited clinical evidence, no comprehensive guidelines exist for opioid switching. This study employed the Side Effect Resource (SIDER) database, which aggregates adverse event data from clinical trials and package inserts, to analyze the side effects of five commonly used “strong opioids” in palliative care in Japan: morphine, fentanyl, oxycodone, hydromorphone, and tapentadol. Methods: Data on adverse event names and incidence rates for each opioid were extracted from SIDER 4.1, developed by the Max Delbrück Center for Molecular Medicine. Cluster analysis and principal component analysis were performed to interpret the data. Results: The key side effects for the opioids were nausea, vomiting, constipation, and drowsiness. Fentanyl was more frequently associated with nausea and vomiting but less often with constipation and drowsiness. Tapentadol caused nausea relatively more often and constipation less frequently. Oxycodone was prominently linked to drowsiness, whereas morphine-induced constipation and drowsiness more frequently. Hydromorphone was associated with higher rates of constipation and vomiting but fewer incidences of nausea and drowsiness. Conclusions: All the side effects characterizing the opioids were related to μ-opioid receptor stimulation, although the present findings highlight differences in the frequency of specific side effects among the opioids. These results provide objective insights that can guide opioid switching in response to adverse effects.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14051410

Authors: Risako Hirai, Motoki Kei, Yoshihiro Uesawa

Institutions: Meiji Pharmaceutical University, Tokyo Women's Medical University Adachi Medical Center, Tokyo Women's Medical University

Language: English

Topic: Pain Management and Opioid Use

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137