Manual on the Use of Essential Palliative Care Medicines for Adults
The Manual provides practical recommendations for the safe and effective use of the medications for palliative care included in the WHO EML and in the Lancet Commission Report. It is organized by the most common and burdensome symptoms in palliative care, listed alphabetically for ease of reference. Each medication is described in terms of a starting dose; dosing frequency, increases, and reductions; maximum daily dose; and precautions. These recommendations are intended for primary care practice for adults in a community setting, prioritizing safety.
Authors
Tania Pastrana, MD; Liliana De Lima, MHA; Russell Portenoy, MD; Deborah Dudgeon, MD; Anna Voeuk, MD; Ebtesam Ahmed, PharmD; and Lukas Radbruch, MD.
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Copyright © 2025 IAHPC Press
© All rights reserved. The information included in this Manual is intended for educational and advocacy purposes only. This Manual may not be sold for commercial purposes.
Library of Congress Cataloging-in-Publication Data
ISBN: 978-0-9989787-7-2
Citation
Pastrana T, De Lima L, Portenoy R, Dudgeon D, Voeuk A, Ahmed E, Radbruch L. IAHPC Manual on the Use of Essential Medicines for Palliative Care. Houston: IAHPC Press; 2025.
Cover photo by Karen Gschwend, in Knysna, South Africa, depicting a staff member of Knysna Sedgefield Hospice visiting a patient at her home. Photo submitted to the 2023 IAHPC Photo Contest. Used with permission.
Disclaimer
The Information included in this Manual is presented as is, and should not be relied upon as complete or accurate, nor should it be relied on to suggest a course of treatment for a particular individual. This Manual reflects the opinion of palliative care workers and experts from around the globe.
The treatment of the underlying cause should be considered, if possible. Non-pharmacological interventions are not included in this Manual but should always be implemented when appropriate. Physicians and pharmacists are encouraged to review the cited guidelines, as well as any others applicable in their own settings, and consult with experts as needed. Patients with health care related questions or concerns are advised to contact their physician and their pharmacist.
The IAHPC gives no warranty and accepts no responsibility or liability for the accuracy, or the completeness of the information and information contained in this Manual, and cannot be held liable for its use. Under no circumstances will the IAHPC be held responsible or liable in any way for any claims, damages, losses, expenses, costs, or liabilities whatsoever (including, without limitation, any direct or indirect damages for loss of profits, business interruption or loss of information) resulting or arising directly or indirectly from the use of this Manual. Before using any medication, it is the responsibility of the health care professional to consult the manufacturer's product information and other reliable sources to check recommended doses, warnings, and contraindications.