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South Staffordshire Joint Formulary
Cannock Chase Clinical Commissioning Group
East Staffordshire Clinical Commissioning Group
South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group
Stafford and Surrounds Clinical Commissioning Group
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.07.02  Expand sub section  Opioid analgesics
 note 

The Faculty of Pain Medicine has produced resources for healthcare professionals around opioid prescribing:www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware

MHRA safety leaflet: Opioid medicines and the risk of addiction

Codeine Phosphate
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Formulary
Green
Codeine Phos Tablet 15mg
Codeine Phos Tablet 30mg
Codeine Phos Tablet 60mg
Codeine Phos Linctus 15mg/5ml S/F
 
   
Controlled Drug Dihydrocodeine Tartrate
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Formulary
Green
Dihydrocodeine Tartrate Tablet 30mg 
   
Controlled Drug Tramadol
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Formulary
Green
Tramadol HCl Capsule 50mg

Tramulief SR 100 mg tablets
Tramulief SR 150 mg tablets
Tramulief SR 200 mg tablets

ONLY use M/R Preparation if compliance really is a problem 
Link  Tramadol and seizures - MHRA CSM Guidance 1996
Link  UKMI Q&A: risk of developing Serotonin Syndrome following concomitant use of tramadol with selective serotonin reuptake inhibitors (SSRIs)
   
Controlled Drug Morphine Sulfate - Oral Solution
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Formulary
Green
Morph Sulfate Oral Solution 10mg/5ml (POM)
Morph Sulfate Oral Solution 20mg/1ml (Controlled Drug)
 
   
Controlled Drug Morphine Sulfate (ZOMORPH CAPSULES)
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Formulary
Green

Zomorph Capsule 10mg M/R
Zomorph Capsule 30mg M/R 
Zomorph Capsule 60mg M/R  
Zomorph Capsule 100mg M/R 
Zomorph Capsule 200mg M/R 
 
 
Prescribe M/R Capsules as brand Zomorph in preference to M/R Tablets as more cost effective. Please prescribe by brand to avoid medication errors (Applicable in Primary care only).

 
   
Controlled Drug Oxycodone
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Formulary
Green

Shortec Capsule 5mg 
Shortec Capsule 10mg 
Shortec Capsule 20mg

Longtec HCl Tablet 5mg M/R
Longtec HCl Tablet 10mg M/R 
Longtec HCl Tablet 15mg M/R
Longtec HCl Tablet 20mg M/R 
Longtec HCl Tablet 30mg M/R
Longtec HCl Tablet 40mg M/R 
Longtec HCl Tablet 60mg M/R
Longtec HCl Tablet 80mg M/R

Longtec HCl Tablet 120mg M/R

Oxycodone HCl Oral Solution 10mg/1ml S/F
Oxycodone HCl Oral Solution 5mg/5ml S/F

 

Please prescribe the normal release as Shortec® and the modified release as longtec® as this is more cost effective (Applicable in Primary care only).

 
   
Controlled Drug Fentanyl
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Formulary
Green

Fencino Transdermal Patch 12mcg/hr
Fencino Transdermal Patch 25mcg/hr
Fencino Transdermal Patch 50mcg/hr
Fencino Transdermal Patch 75mcg/hr
Fencino Transdermal Patch 100mcg/hr

Useful if patient cannot swallow tablets
Prescribe by Brand - Fencino recommended 
(Applicable in Primary care only). 

 
   
Controlled Drug Buprenorphine 5mcg Patch (BuTec patch)
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Restricted Drug Restricted
Green

Please prescribe by brand Butec® (equivalent to Butrans®) as more cost effective (Applicable in Primary care only).

Note: Low dose may be useful for frail elderly patients or similar patients sensitive to side-effects of morphine sulphate or fentanyl

Self-adhesive, beige, buprenorphine, ‘5’ patch (releasing 5 micrograms/hour for 7 days)

See the Strong Opioids for Persistant Non-Cancer Pain Guidelines for further information

 
Link  Strong Opioids for Persistant Non-Cancer Pain Guidelines
   
Controlled Drug Buprenorphine 35mcg Patch (Transtec patch)
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Restricted Drug Restricted
Green

Note: Low dose may be useful for frail elderly patients or similar patients sensitive to side-effects of morphine sulphate or fentanyl

Self-adhesive, skin-coloured, buprenorphine, 35 patch (releasing 35 micrograms/hour for 96 hours)

See the Strong Opioids for Persistant Non-Cancer Pain Guidelines for further information  
Link  Strong Opioids for Persistent Non-Cancer Pain
   
Controlled Drug Diamorphine
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Formulary
Green

Diamorphine Tablets 10mg

5mg Powder for Soln for Injection Ampoules 
10mg Powder for Soln for Injection Ampoules
30mg Powder for Soln for Injection Ampoules
100mg Powder for Soln for Injection Ampoules

500mg Powder for Soln for Injection Ampoules

 
Link  22/05/2019: Diamorphine 5mg injection supply issues
   
 ....
 Non Formulary Items
Controlled Drug  Alfentanyl Sublingual Spray 5 mg in 5mL

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Non Formulary
 
Controlled Drug  Buprenorphine  (Temgesic)

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Non Formulary
 
Controlled Drug  Buprenorphine 5mcg Patch  (Butrans)

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Non Formulary Butrans non-formulary please prescribe branded generic Butec as more cost effective. Butec is made in the same manufacturing unit as Butrans.
 
Controlled Drug  Dextromoramide

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Non Formulary
 
Controlled Drug  Dipipanone  (Diconal)

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Non Formulary
 
Controlled Drug  Fentanyl  (Actiq)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Controlled Drug  Fentanyl  (Effentora buccal tablets)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Controlled Drug  Fentanyl  (Instanyl nasal spray)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Fentanyl Buccal Film  (Breakyl)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Controlled Drug  Fentanyl Nasal Spray  (PecFent)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Controlled Drug  Fentanyl sublingual tablets  (Abstral)

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Non Formulary

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).

 
Controlled Drug  Hydromorphone  (Palladone)

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Non Formulary
 
Controlled Drug  Hydromorphone Hydrochloride  (Palladone SR)

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Non Formulary
 
Meptazinol  (Meptid)

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Non Formulary
 
Controlled Drug  Methadone

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Non Formulary
 
Controlled Drug  Morphine and cyclizine  (Cyclimorph)

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Non Formulary
 
Controlled Drug  Morphine Sulfate  (MST Continustablets)

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Non Formulary

Non formulary as is more cost effective to prescribe as Zomorph capsules

 
Controlled Drug  Morphine Sulfate  (Oramorph)

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Non Formulary

Please prescribe generically

 
Controlled Drug  Morphine Sulfate  (Sevredoltablets)

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Non Formulary
 
Controlled Drug  Papaveretum

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Non Formulary
 
Controlled Drug  Papaveretum

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Non Formulary
 
Controlled Drug  Pentazocine

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Non Formulary
 
Controlled Drug  Pethidine

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Non Formulary
 
Controlled Drug  Pethidine Hydrochloride and promethazine  (Pamergan P100)

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Non Formulary
 
Controlled Drug  Tapentadol  (Palexia)

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Non Formulary
 
Controlled Drug  Targinact (Oxycodone/Naloxone)  (Targinact)

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Non Formulary

NHS England Guidance for CCGs4:

    • prescribers in primary care should not initiate oxycodone and naloxone combination product for any new patient.
    • prescribers should be supported in deprescribing oxycodone and naloxone combination product in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.if, in exceptional circumstances, there is a clinical need for oxycodone and naloxone combination product to be prescribed in primary care, this should be undertaken in a cooperation arrangement with a multi-disciplinary team and/or other healthcare professional.No routine exceptions have been identified. 

 

 
Tramadol Hydrochloride  (Dromadol®SR)

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Non Formulary
 
Tramadol Hydrochloride  (Larapam® SR)

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Non Formulary
 
Tramadol Hydrochloride  (Zamadol®)

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Non Formulary
 
Tramadol Hydrochloride  (Zamadol® SR)

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Non Formulary
 
Tramadol Hydrochloride  (Zydol®)

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Non Formulary
 
Tramadol Hydrochloride and paracetamol  (Tramacet)

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Non Formulary

NHS England Guidance for CCGs:

  • prescribers in primary care should not initiate paracetamol and tramadol combination product for any new patient.
  • prescribers should be supported in deprescribing paracetamol and tramadol combination product in all patients and, where appropriate, ensure the availability of relevant services to facilitate this change.

 

No routine exceptions have been identified.

 
Tramadol MR

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Non Formulary
 
Tramadol oral drops

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs which require special consideration. These are drugs for Consultant Prescribing ONLY. They should not be prescribed in Primary Care.  

Amber

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care. For some drugs there may be a Ricad in place to aid the transition to primary care.  

Amber E

Drugs that should be initiated by a Specialist but are suitable for continuation in Primary Care but also require and ESCA (Shared Care Agreement)   

Green

Suitable first-line drugs for implementation in Primary Care  

On Formulary

South Staffs Formulary Choice  

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