‘Just in case’ medicines in palliative care

What are ‘Just in Case’ medicines?

Also known as ‘anticipatory medicines’, these are medicines which are usually given by injection and are prescribed for you. They are given to you to be kept in your home ‘just in case’ you need them. This means you can be given a medicine to help relieve pain or other symptoms if you need it, especially during the night or at the weekend.

Your usual oral medicines (e.g. pain medication) should be tried first to see if this helps. If they do not help, you or your carer can phone your GP, community nurse or the out of hours community nursing service to come to the house to see you. The GP or community nurse will discuss your symptoms with you and your carer. They may ask you to take an extra dose of your usual medicines if they think that this is what is needed. If you’re unable to swallow your oral medication, are being sick or the medicine isn’t getting to where it needs to work (due to problems with absorption) then the GP or community nurse may give you an injection from your ‘Just in Case’ medicines.

What are the medicines for?

You may not need any of these medicines right now however they have been prescribed for you because your healthcare team think that they may be needed at some point in the coming days or weeks to help with:

  • pain relief
  • sickness/nausea
  • breathlessness or breathing (especially if you’re unable to clear your own throat)
  • anxiety or restlessness

The GP or community nurse who gives you any of the ‘Just in Case’ medicines will assess you to see if the oral medicines you’ve taken or the injection(s) you’ve been given has helped. They will agree a plan with you and your carer about what to do if your usual medicines need changed or another dose of the ‘Just in Case’ medicines is needed.

Who can/should give you ‘Just in Case’ medicines?

Your GP or community nurse will make sure you have a plan in your house which describes your care along with a medicine administration instruction chart for the ‘Just in Case’ medicines. The community nurse will use this chart to allow them to check and give the correct medicine and dose to help relieve your symptoms. Having these documents in your home means you do not have to wait for a GP to come out to see you.

Some patients or their carers may wish to be involved in the administration of injectable ‘Just in Case’ medicines. If this is something that you would like to consider please discuss this with your GP and community nurse. You or your carer will need to be taught about the medicines, when they can be given, how to give the injection, how to record that the medicine has been given and who to contact for support. In some NHS Board areas the administration of injectable ‘Just in Case’ medicines may be restricted to healthcare professionals only.

If you or your carer is administering the ‘Just in Case’ medicines you will have a plan available in your house about your care with instructions on what you should do if you have to give the medicines. You will also be provided with the equipment required to give an injection (needles, syringe, sharp item disposal – ‘sharps’ – bin).

How do I look after my ‘Just in Case’ medicines?

The medicines have been prescribed for you and should not be given to or taken by anyone else. The ’Just in Case’ medicines are kept in your home. Keep them in a safe place out of the reach of children or other vulnerable people. They do not need to be kept in a fridge. Let your healthcare team know where they are stored.

When you receive your ‘Just in Case’ medicines, your carer or the community nurse should check and note the expiry date of each medicine. The expiry dates should be checked each month. If your ‘Just in Case’ medicines expiry date is near, let your GP practice or community nurse know so that a prescription can be obtained to get a new supply of your ‘Just in Case’ medicines.

If any of the medicines are needed, the supply is just enough to last until more can be obtained. Contact your GP practice or community nurse so that a new prescription can be obtained to replace the ones that have been used if needed.

If your condition changes, you or your carer should let your GP or community nurse know so that they can reassess you and make sure your regular medicines and ‘Just in Case’ medicines, and their doses, are still right for you.

If you’re admitted to hospital or another care setting, the medicines can go with you as they have been prescribed for you. If you’re unable or do not wish to do this, please let the staff know that you have them in the house.

If ‘Just in Case’ medicines or any other medicines are no longer needed, they should be returned to your community pharmacy or dispensing doctor.

Any questions?

If you have any questions about your ‘Just in Case’ or usual medicines, please talk to your GP, community nurse, or other health care professional.

Last updated:
01 May 2024