This section gives an overview of the commonly used drugs (excluding opioids) to manage symptoms in patients with terminal illnesses. The information includes basic dosage information as well as indications for use and potential side effects. Please note that non-opioid drugs commonly used in palliative care in Singapore are shown here but the list is NOT exhaustive and neither are the side effects nor indications. Doses are for adults only. Please check with pharmacy colleagues for dose adjustments (if any) in renal or liver impairment. Unless otherwise indicated, use water for injection for dilution in continuous subcutaneous infusions.
*For information on opioids, please search and refer to the drugs with their given context.
Methylphenidate
Route, Dosage and Frequency
ROUTE
|
DOSAGE AND FREQUENCY
|
| PO |
Start 2.5-5mg each morning and noon. Gradually increase as needed (max dose 20mg b.d.) |
Other Information
Indications
Opioid induced drowsiness, Severe depression. Evidence for use in fatigue is poor.
Side-Effects
Headache, Agitation, Insomnia.
Remarks
Psychostimulant. For severe depression, methylphenidate may be started alongside antidepressants while waiting for the latter to work. Or it can be used for severe depression in patients with prognosis 2-4 weeks because of its faster onset.
Reference
- Watson M. Oxford Handbook of Palliative Care. Oxford, NY: Oxford University Press; 2009.