Currently my mum is only taking paracetamol for ear and throat pain. She has hypopharyngeal cancer and is having palliative radiotherapy. She cannot take ibuprofen as advised by her gp a while ago.

We will be seeing the head and neck cancer specialist nurse on monday and will ask her this, but wanted some ideas ahead of time.

What would be the next step in pain relief?

Mum has had codeine several times in the past and couldn't stand the constipation side effects. She has also had amitriptaline and gabapentin for neuropathic pain in the past which she didn't like either. 

I know there are only so many options out there and she may need to take codeine, amitriptaline or gabapentin, but I wondered if any of you had been offered an alternative.

Thank you xx