What are anticipatory (Just in Case) medications?

Anticipatory medications are a small supply of injectable medicines to keep at home, just in case you need them, for symptoms that you might experience in the future. It is common in the last days of life to become too weak to swallow oral medications. Anticipatory medications are prescribed in advance as sometimes it can be difficult to get the medicines you need in time to treat a new symptom, especially at night or weekends. Most patients do not need to use these medicines but it can be reassuring to know they are available.

What are anticipatory medications for?

Anticipatory medications have been chosen to meet your particular needs and treat different symptoms you might experience. You may not need all the medicines listed below or may be given different medicines depending on your condition. These medicines are all injections and can commonly include:

  • Morphine sulfate/Oxycodone – to reduce pain and/or shortness of breath

  • Midazolam – to help ease anxiety or agitation

  • Glycopyrronium – to help ease noisy chest secretions

  • Levomepromazine/Haloperidol – to reduce nausea and vomiting

Do anticipatory medications cause side effects?

All medicines can cause side effects. Side effects you may experience vary depending on your condition and other medicines you are taking but may include sickness, drowsiness or a dry mouth. If you need any of these medicines the potential side effects will be discussed with you.

Further information is also available in the patient information leaflet that comes with your medicine.

How are these medicines given?

When you have symptoms try your usual oral medicines (e.g. painkillers) first to see if they help. If these do not help, contact your GP, community nurse or the palliative care team for advice. They may recommend the use of your anticipatory medications. Your anticipatory medications should only be given by a healthcare professional involved in your care and will be discussed with you. You cannot give yourself these medicines, neither can a family member or friend. These medicines are given as an injection under the skin (subcutaneous route) and are useful if you find swallowing medicines difficult, for example, if you are drowsy or being sick.

How do you look after and store your medicines?

These medicines have been prescribed for you only. They should not be given to or taken by anyone else. Store these medicines safely in the original containers in a cool, dry place, away from direct heat or light.

Keep them out of reach or sight of children. Your District Nurse / Nursing Home staff will receive a ‘drug authorisation sheet’ to allow them to administer the medication if needed, and they will keep a register of medications.

When the medicines are no longer needed, your District Nurse will destroy them at your home.

Useful contact details

If you have any questions or concerns about your medicines, please speak to a healthcare professional involved in your care at home (GP, District Nurses or Community Pharmacy).

Additional advice can be sought from:

Hospital Palliative Care Team, Lancashire Teaching Hospitals NHS Foundation Trust

  • 01772 522 055
  • Opening hours: 8.30am to 4.30pm, Monday–Friday
  • 01772 725 656 (Switchboard), Bleep 7070 (8.30am to 4.30pm, weekend and bank holidays)

St. Catherine’s Hospice Advice Line: 01772 629 171

Please ask if you would like help in understanding this information. This information can be made available in large print and in other languages.

This leaflet is for central Lancashire use only.