Ways of taking cancer painkillers
There are different types of painkillers and ways of taking them. Your medical team will find the best painkiller for you.
About cancer and painkillers
There are lots of different types of painkillers. They treat different levels and types of pain. Painkillers are usually prescribed by doctors, but some nurses can also prescribe them.
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Taking painkillers regularly
Pain that continues for more than 3 months is often called chronic or persistent pain. If you have chronic pain, you may need to take painkillers regularly to control it.
Always take your painkillers at regular intervals as prescribed. This is important to make sure they work as well as possible. The aim is for pain control to be constant, so you should not be in pain when you take the next dose. Delaying taking painkillers can make your pain worse. It may then take more time and a higher dose of painkillers to get your pain back under control.
If you have been given painkillers for breakthrough pain, do not wait for the pain to get bad before taking them.
It is important to tell your doctor or nurse if your pain gets worse. They can then treat it before it becomes harder to control. You may need your painkiller dose changed or have a different painkiller. It can sometimes take time to get the right painkiller and dose.
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Ways of taking painkillers
There are different ways you can take painkillers, depending on which ones you need. If you find it difficult taking painkillers a certain way, talk to your doctor or nurse, as there may be another way you can take them.
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Tablets and capsules
You usually take painkillers as tablets or capsules. Tell your doctor or nurse if you find these hard to swallow. Many painkillers are available as liquids and some can be dissolved in water.
If you have a feeding tube, you can have some liquid or soluble painkillers through it.
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Skin patches
Some painkillers can be absorbed through the skin. You have these as a patch you put on your skin. This slowly releases a constant amount of painkiller. A patch can be helpful for people who have difficulty swallowing or find it hard to remember to take their painkillers regularly. Your cancer team will tell you how to use the patches and how often you need to change them.
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Buccal and sublingual medicines
These painkillers are absorbed through the lining of your mouth, so you do not have to swallow. You put them between your gum and your cheek (buccal) or under your tongue (sublingual).
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Injections
You can also have painkillers as an injection:
- under the skin (subcutaneous)
- into a muscle (intramuscular)
- directly into a vein (intravenous).
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Suppositories
Some painkillers can be put into the back passage (rectum). The drug is absorbed through the lining of the rectum. Having painkillers put into the back passage is not painful. The nurse will use a lubricating gel so that it goes in easily. A nurse can teach you how to put them in yourself if you would prefer.
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Gels or creams you put on skin
If the pain is in 1 area (local), rubbing a gel or cream on to the skin may help. For example, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are available as gels. There are also gels or plasters that contain local anaesthetics.
Creams containing menthol may also help with pain. Another cream called capsaicin may be used to treat nerve pain. Capsaicin is the substance that makes chilli peppers hot. Your doctor needs to prescribe this. There have been some stock issues throughout the UK so it may not be available.
Ask your doctor or nurse for advice first. Do not use any gels or creams on skin that is inflamed or broken. Wash your hands after applying any cream or gel. Always tell your doctor, nurse or pharmacist that you are using them.
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Nasal sprays
Some painkillers can be sprayed into the nose. They are absorbed through the lining of the nose.
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Gas and air (Entonox®)
This is a painkiller that you breathe in. You sometimes have it before procedures to help reduce pain. These may include a bone marrow test or a dressing change. It is only available in some hospitals.
Having painkillers through a pump
Painkillers are sometimes given continuously over a set time through a pump. There are different types of pumps used for different reasons. A syringe containing the painkiller is placed in the pump and connects through a tube to 1 of the following:
- A thin small plastic tube placed just under the skin. The pump is called a syringe pump. It can be used to manage cancer pain and other symptoms.
- A fine needle placed into a vein. This is usually done after surgery for short-term pain control.
- A fine plastic tube placed in your back that goes into the space around your spinal cord (epidural and intrathecal). This is done by an anaesthetist and used after certain types of surgery. But it can also be used to control cancer pain that is difficult to manage.
Syringe pump
A syringe pump is a small portable pump that can be used to give different medicines. It is sometimes called a syringe driver.
A syringe pump may be used if:
- you are feeling, or being sick
- it is difficult for you to swallow tablets
- your pain is not being well controlled with tablets or injections.
A syringe containing the painkiller is attached to the pump. The pump delivers a continuous dose through a small, thin plastic tube placed just under your skin. You can also have other drugs through a syringe pump, such as anti-sickness drugs.
A nurse usually changes the syringe every 24 hours. You can have a syringe pump for as long as you need it. This might be at home or in hospital.
Having a syringe pump does not stop you moving around as usual. You can carry it in a pocket or bag. You can go out shopping or for a meal wearing the pump.
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About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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ReferencesBelow is a sample of the sources used in our cancer pain information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
ESMO Management of Cancer Pain in Adult Patients. ESMO Clinical Practice Guidelines. 2018. Available from: www.esmo.org/guidelines/esmo-clinical-practice-guideline-cancer-pain [accessed 24/03/2025].
NICE Palliative cancer care: Pain. 2025. Available from: cks.nice.org.uk/topics/palliative-cancer-care-pain/management/managing-pain-non-emergency/#management-of-breakthrough-pain [accessed 17/02/2025].
Scottish Palliative Care Guidelines. Available from: https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/ [accessed 17/02/2025].
Date reviewed
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