Pain is commonly observed in the terminal phase of a palliative illness when it is usually expressed as agitation.

For support with switching between opioids, refer to Opioids: Switching Between Formulations.

Prescribing Guidance

The CareSearchgp App provides prescribing information on this issue

The palliMEDS app provides GPs with advice on managing this symptom with palliative care medicines endorsed by the Australian & New Zealand Society of Palliative Medicine (ANZSPM). The app is a collaboration between NPS MedicineWise and caring@home.

Tasmanian Adult Palliative Care Formulary

Therapeutic Guidelines: Palliative Care (subscription required)

Useful information

Therapeutic Guidelines: Palliative Care (subscription required)

Carers may find the information in this leaflet useful: Learn more about pain and pain management by Palliative Care Australia.


  • Always be aware that if a person stiffens and resists, vocalises, or grimaces during routine nursing care, this may be a sign that they are experiencing pain.
  • It is vital for breakthrough analgesia to be given when the source of restlessness is identified as pain.
  • Look out for non-verbal signs of pain and explain to family and carers before responding with a breakthrough dose.

Page last updated 12 March 2024