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. 2012 Jul 19;2(4):e000731. doi: 10.1136/bmjopen-2011-000731

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© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Five levels of analgesic potency, modified from the WHO analgesic ladder.¹⁶ Level 1 (ie, lowest potency) to level 5 (ie, highest potency). (a) Gabapentin and pregabalin in the absence of other anti-epileptic drugs. (b) Carbamazepine, valproic acid and lamotrigine in combination with medication at level 1 or 2. (c) Tramadol and codeine. (d) Methadone, oxycodone, hydromorphone, morphine, buprenorphine, fentanyl, sufentanil and pethidine.