4.6.1.2 Opioids

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

Butec patches are the most cost effective preparation for this strengthControlled drugs should be prescribed by brand Buprenorphine patches should be
prescribed in accordance with the Chronic Pain Guidelines: http://tinyurl.com/znwuw7f

On formulary only for use as strong analgesic for the relief of moderate to severe pain NOT for opioid substitution

On formulary only for use as strong analgesic for the relief of moderate to severe pain NOT for opioid substitution

DO NOT PRESCRIBE. All services are commissioned through Turning Point and patients should be referred back to Turning Point to obtain supplies to
ensure this is only supplied with the required behavioural support. In the event of a request for an emergency supply. DO NOT PRESCRIBE. All patients
are notified that Turning Point can be contacted 24/7 to discuss and, if appropriate, obtain an additional prescription. Other substance abuse services will
have a similar arrangement. Contact details for Turning Point are Referrals (24/7 Helpline) Advice: 0300 123 1186.

DO NOT PRESCRIBE. All services are commissioned through Turning Point and patients should be referred back to Turning Point to obtain supplies to
ensure this is only supplied with the required behavioural support. In the event of a request for an emergency supply. DO NOT PRESCRIBE. All patients
are notified that Turning Point can be contacted 24/7 to discuss and, if appropriate, obtain an additional prescription. Other substance abuse services will
have a similar arrangement. Contact details for Turning Point are Referrals (24/7 Helpline) Advice: 0300 123 1186.

DO NOT PRESCRIBE unless you are one of the very few practices in East Kent which have a contract for Opioid substitution therapy services. All
services are commissioned through Turning Point and patients should be referred back to Turning Point to obtain supplies to ensure this is only supplied with the required behavioural support .In the event of a request for an emergency supply. DO NOT PRESCRIBE. All patients are notified that Turning Point can be contacted 24/7 to discuss and if appropriate, obtain an additional prescription. Other substance abuse services will have a similar arrangement.Contact details for Turning Point are Referrals, 24/7 Helpline, Advice 0300 123 1186

DO NOT PRESCRIBE unless you are one of the very few practices in East Kent which have a contract for Opioid substitution therapy services. All
services are commissioned through Turning Point and patients should be referred back to Turning Point to obtain supplies to ensure this is only supplied with the required behavioural support .In the event of a request for an emergency supply. DO NOT PRESCRIBE. All patients are notified that Turning Point can be contacted 24/7 to discuss and if appropriate, obtain an additional prescription. Other substance abuse services will have a similar arrangement.Contact details for Turning Point are Referrals, 24/7 Helpline, Advice 0300 123 1186

Prescribe generically

prescribing as zapain is more cost effective

prescribing as zapain is more cost effective

Prescribe generically.Capsules should be reserved for patients who cannot swallow tablets. Tablets are more cost effective.

Limited evidence base to support this dose of codeine

Limited evidence base to support this dose of codeine

Mezolar or Matrifen are most cost effective preparations. Prescribe by brand in line with recommendations for Controlled Drugs

Mezolar or Matrifen are most cost effective preparations. Prescribe by brand in line with recommendations for Controlled Drugs

Mezolar or Matrifen are most cost effective preparations. Prescribe by brand in line with recommendations for Controlled Drugs

Mezolar or Matrifen are most cost effective preparations. Prescribe by brand in line with recommendations for Controlled Drugs

Mezolar or Matrifen are most cost effective preparations. Prescribe by brand in line with recommendations for Controlled Drugs

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Hospice recommendation only. (Updated: January 2015)

Consider using Sevredol for use in chronic pain in place of Oramorph. Controlled drugs should be prescribed by brand

Consider using Sevredol for use in chronic pain in place of Oramorph. Controlled drugs should be prescribed by brand

Consider using Sevredol for use in chronic pain in place of Oramorph. Controlled drugs should be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine capsules. Controlled drugs should be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine capsules. Controlled drugs should be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine capsules. Controlled drugs should be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine capsules. Controlled drugs should be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine capsules. Controlled drugs should be prescribed by brand

For use for breakthrough pain in chronic pain consider immediate release morphine (Sevredol) in place of Oramorph.

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Zomorph is the most cost effective preparation for 12 hour modified release morphine although a capsule form rather than a sachet. Controlled drugs should
be prescribed by brand

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.
MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Oxycodone and morphine sulfate have a similar safety and efficacy profile, however morphine sulfate is significantly less costly than oxycodone.

MORPHINE sulphate should therefore be considered first line where strong opioids are required.

Targinact is not recommended as the clinical benefit in patients receiving regular laxative therapy is uncertain and the economic case for use was not proven (in line with the Scottish Medicines Consortium advice June 2009) (Updated: July 2015)

Targinact is not recommended as the clinical benefit in patients receiving regular laxative therapy is uncertain and the economic case for use was not proven (in line with the Scottish Medicines Consortium advice June 2009) (Updated: July 2015)

Targinact is not recommended as the clinical benefit in patients receiving regular laxative therapy is uncertain and the economic case for use was not proven (in line with the Scottish Medicines Consortium advice June 2009) (Updated: July 2015)

Targinact is not recommended as the clinical benefit in patients receiving regular laxative therapy is uncertain and the economic case for use was not proven (in line with the Scottish Medicines Consortium advice June 2009) (Updated: July 2015)

Preferred brand where Tramadol is indicated

Preferred brand where Tramadol is indicated

Preferred brand where Tramadol is indicated

Tramacet not recommended due to sub-therapeutic dose of paracetamol

Specialist initiation where morphine and/or oxycodone have failed to provide adequate pain control; or have been tried and not tolerated’

Specialist initiation where morphine and/or oxycodone have failed to provide adequate pain control; or have been tried and not tolerated’

Specialist initiation where morphine and/or oxycodone have failed to provide adequate pain control; or have been tried and not tolerated’

Specialist initiation where morphine and/or oxycodone have failed to provide adequate pain control; or have been tried and not tolerated’

Specialist initiation where morphine and/or oxycodone have failed to provide adequate pain control; or have been tried and not tolerated’

Not on EKHUFT formualry