Healthcare professionals are asked to plan for a permanent move to morphine sulphate injection as opioid of choice, where clinically appropriate, in place of diamorphine 5mg and 10mg.
Suppliers Wockhardt and Accord have indicated that full supply of these items are unlikely before Summer 2020. Manufacturers of diamorphine hydrochloride 30mg ,100mg, 500mg, which remain available, say they are unable to support an increase in demand on these strengths.
All healthcare professionals in primary care who prescribe, dispense or administer diamorphine hydrochloride injection 5mg and 10mg should:
- identify a local lead within their organisation to manage the delivery of actions as advised in this document where possible
- review and update guidelines and protocols, moving to morphine sulphate injection as opioid of choice, where clinically appropriate, in place of diamorphine 5mg and 10mg
- identify and deliver required education and training to General Practice and community nursing teams to support the switch over to morphine;
- ensure no new patients are started on diamorphine hydrochloride 5mg or 10mg injection
- review patients currently receiving diamorphine 5mg or 10mg injection and manage the switch to an alternative opioid
- not switch patients to higher strengths of diamorphine injection as there is insufficient stock to support increased use
- consider morphine 10mg/ml injection as the first line opioid as supplies of alternative opioid agents are limited and these should be prescribed for patients where morphine is not clinically appropriate
- place orders for morphine sulfate 10mg/1ml solution for injection ampoules (Ethypharm (Martindale) and Hameln) from major wholesalers.
View the alert.