Opioids: Which One Do I Take?
Short and long-acting opioids are often prescribed together. They do different things to keep pain under control.
As a reminder:
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Short-acting opioids are medications that you can take as needed, when you feel pain.
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Long-acting opioids are taken on a regular schedule to keep your pain under control.
Understanding opioid names
It can be confusing to know which medicine is your long-acting opioid, and which is your short-acting opioid. It doesn’t help that these medicines often have very similar names and might be made of the same active medicine (like morphine or oxycodone).
If you aren’t sure, check My Medicine Cabinet to see which medicine is your short-acting and which is your long-acting opioid.
Both morphine and oxycodone come in both short- and long-acting versions. Here's a list of common morphine-based and oxycodone-based opioids:
Morphine
Short-Acting
Morphine Sulfate IR
MS IR
Long-Acting
Morphine Sulfate ER
MS ER
MS Contin
Oxycodone
Short-Acting
Oxycodone IR
OxyIR
Roxicodone
Long-Acting
OxyContin
Here are some common terms you might see on your prescription that will help you tell the difference between short- and long-acting opioids:
Common term
What it stands for
Examples
IR
Immediate release
(short-acting)
morphine IR
MS IR
OxyIR
ER
Extended release
(long-acting)
morphine ER
Contin
Continuous release
(long-acting)
MS Contin
OxyContin
TD
Transdermal patch
(long-acting)
Fentanyl TD patch
*Some prescriptions include the terms “HCL” or “sulfate,” which refers to the chemical make-up of the drug. These terms don’t help you know if it is short or long-acting.
Common questions when using short- and long-acting opioids
Here are some common questions that may come up as you use short- and long-acting opioids:
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Always follow the instructions on your prescription bottle.Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
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Take them when you have pain and need quick relief.These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
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If you don’t have pain, don’t take them.If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
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Take them before your pain gets severe.Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
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Choose the dose that matches your pain level.Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
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Take them about 30 minutes before painful activities.Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
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If your short-acting opioid is not working well, talk to your care team.Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
Want to learn more?
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