Preventing overmedication in patients with breakthrough pain

Breakthrough pain is treated with a continuous hourly dose (solid black line) plus immediate access to additional smaller doses of pain medication when needed, preferably by patient-controlled analgesia (PCA). If the total hourly dose is raised higher (dotted black line) to eliminate all breakthrough pain, the patient is likely to become overmedicated and have increased opioid side effects. Refer to UpToDate content on sickle cell pain treatment for further details.