PAD - Prescribing Advisory Database
PLEASE NOTE : This is a development system.

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PAD Profile : Morphine sulfate - Pain

Keywords :
Strong opioids, analgesia, opioid analgesics
Brand Names Include :
MST, Morphgesic, Sevredol, Zomorph, MXL, Oramorph,

Traffic Light Status

Status 1 of 4.

Status :
Green (see narrative)
Important
Formulations :
  • Immediate release tablets
  • Oral solution
  • Oro-dispersible
Important Information :
Orodispersible tablets are a cost-effective alternative to oral solution. Reserve oral solution and orodispersible tablets for patients in whom a solid dose form is not suitable.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 2 of 4.

Status :
Red
Important
Formulations :
  • Injection
  • Solution for infusion
Important Information :
See separate listing for palliative care
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 3 of 4.

Status :
Green (see narrative)
Important
Formulations :
  • Capsules (slow release)
  • Granules (slow release)
  • Tablets (slow release)
Important Information :
Prescribe modified-release preparations by brand - refer to local guidelines for preferred brands. Zomorph capsules (12-hourly) can be opened for administration in patients unable to swallow the capsules.
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Status 4 of 4.

Status :
Non Formulary
Formulations :
  • Suppositories
Trust Alignment :
Primary Care
ASPH
RSFT
SASH
SABP
Links :
BNF NICE SPC
CD
Comments :
No comments returned.
Documents :

Guidelines

The following guidelines are available for this indication.

Other Drugs

Other Indications

No indications returned.

Additional Documents

Committee Recommendations

Date
Committee Name
Narrative
07 August 2019
Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

Zomorph® is the locally preferred brand of morphine sulfate modified release (12-hourly formulation). 

Branded prescribing is recommended for morphine sulfate MR preparations by UKMi (see branded prescribing guidance below). Prescribers should identify patients currently prescribed generic preparations and change to the preferred branded product – Zomorph®.

Key points for consideration:
- Prescribers should be aware that there is no 5mg Zomorph® available so may wish to initiate MST® as the preferred brand if 5mg presentation is required.
- Switching MST® to Zomorph® is an option as they are bioequivalent.
- MXL is the only brand available for 24 hour preparations
- Zomorph® capsules can be opened and administered orally or via a tube – granules / capsules should not to be crushed

06 June 2018
Surrey & North West Sussex Area Prescribing Committee (formerly Prescribing Clinical Network)

A stepped approach to pain management is recommended. Morphine is the 1st line  treatment option where a strong opioid is indicated. Please refer to the guidelines attached.

It is recommended  that morphine oral modified release (MR) preparations are prescribed by BRAND - see UKMI Branded Prescribing Recommendations document below. Patients currently receiving generically written prescriptions for morphine MR preparations should be reviewed with a view to changing the prescribing to a more cost-effective brand.
Please note that Zomorph® capsules can be opened up for patients who are unable to swallow.

Ensure a patient agreement is completed by the patient (see below) prior to a trial of Morphine

Associated BNF Codes

04. Central Nervous System
04.07.02. Opioid analgesics
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