The Pennine Acute Hospitals
NHS Trust Formulary
 
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4 Central nervous system
04-07-02 Opioid analgesics

Codeine Phosphate
First Choice
Tablets
Oral liquid
Link  MHRA Alert: Codeine restrictions in children, adolescents and in breastfeeding mothers
Link  UKMi Q&A: Codeine and breastfeeding - is it safe and what are the alternatives?
 

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Morphine
First Choice
Oral solution:
  • 10mg/5mL
  • 100micrograms/mL (unlicensedunlicensed)

    Concentrated oral solution:
  • 100mg/5mL

    Tablets

    M/R 12-hourly oral preparations:
  • Zomorph capsules
  • MST tablets

    M/R 24-hourly oral preparations:
  • MXL capsules

    Suppositories

    Injection

    PCA syringe (unlicensedunlicensed)


  • Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Tapentadol Palexia®
    Third Choice

    Prolonged-release tablets


    Tablets


    Oral solution



    • Third or fourth line option in those patients who have failed other therapies and are intolerant to oxycodone.

    • To be prescribed or initiated under the advice of a specialist in pain management only.

      Grey Traffic Light Use of this agent should be restricted to those patients requiring treatment of severe chronic pain which CANNNOT be managed with more established opioid therapies.

    Link  GMMMG recommendation: Tapentadol for treatment of severe pain
    Link  MHRA Safety Alert: risk of seizures and reports of serotonin syndrome
     

    Controlled Drug  Grey View adult BNF  View SPC online  View childrens BNF
    Buprenorphine
    Formulary
    Patches (BuTrans or Transtec)
    S/L tablets (Temgesic)

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Diamorphine
    Formulary
    Injection

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Dihydrocodeine
    Formulary
    Tablets
    M/R tablets

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    Fentanyl
    Formulary
    Patches
    Restricted Item Buccal tablets (Effentora) Palliative care only
    Restricted Item Nasal spray (PecFent) Palliative care only
    Link  GMMMG IPNTS Recommendation: Fentanyl preparations
    Link  MHRA Safety Alert: Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure
     

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Oxycodone
    Formulary
    Immediate-release preparations (OxyNorm):
  • Oral solution 5mg/5mL
  • Concentration oral solution 10mg/mL
  • Capsules
  • Injection

    M/R preparations (OxyContin):
  • Tablets

  • Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Pethidine
    Formulary
    Tablets
    Injection

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Tramadol
    Formulary
    Capsules
    Soluble tablets
    M/R tablets or capsules
    Injection
    Link  UKMI Q&A: risk of developing Serotonin Syndrome following concomitant use of tramadol with SSRIs
     

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Fentanyl Actiq®
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Fentanyl Instanyl® nasal spray
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Fentanyl sublingual tablets Abstral®
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Hydromorphone Palladone®
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Meptazinol Meptid®
    Non Formulary

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    Morphine and cyclizine Cyclimorph®
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Papaveretum
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Pentazocine
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Pethidine Hydrochloride and promethazine Pamergan® P100
    Non Formulary

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF
    Tramadol Hydrochloride and paracetamol Tramacet®
    Non Formulary

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    Targinact® (Oxycodone/Naloxone)
    Non Formulary
    Link  GMMMG Recommendation: Targinact
     

    Controlled Drug  View adult BNF  View SPC online  View childrens BNF