SALVADOR, E.    ALIAGA, L.. Opioid combination. []. , 23, 3, pp.159-163. ISSN 1134-8046.

The basic premise of an analgesic combination is that the two drugs act through different mechanisms of action; thus, the combination may be a reduction in adverse effects associated with the dose. However, the usefulness of the joint administration of drugs of the same pharmacological group is a controversial argument but is effective in some diseases, such as depression and epilepsy. The rapid need for increased doses of opioids is a challenge for physicians and represents a critical phase for patients who have a poor pain control despite receiving progressively increasing doses of opioids. The administration of small dose of a second opioid in patients with an unfavorable response during the escalation of the previous opioid has been found effective in a preliminary report which were added: oral morphine, transdermal fentanyl and oral methadone transdermal fentanyl oral morphine and oral morphine, respectively. Thus, although in clinical practice multiple opioids are often administered simultaneously for different reasons, few studies have evaluated this specific issue.

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