SEVEN day patches only to be prescribed (brands are interchangeable)

Hospital prescriber to prescribe generically and contract patches to be supplied

(To be prescribed as Sevodyne patches in Primary Care - 5,10,15 and 20mcg/hr)

Only for use in patients who are unable to take or tolerate oral medicine (including soluble tablets and liquids) OR where use of the low-dose buprenorphine patches may prevent administration problems for frail, elderly patients in the Community.

Transdermal preparations lack the flexibility required when treating patients with fluctuating or uncontrolled pain. Use should be reserved for patients with stable pain who are unable to take or tolerate oral medicines. Buprenorphine patches are several times more expensive than equivalent doses of oral analgesics, and inappropriate use of transdermal preparations has cost implications for commissioners. It is recommended that the reason for using a patch is documented on initiation and, if appropriate, patients are switched to oral formulations at the earliest opportunity.

**Under review**

s/l tablets 200micrograms

See section 4.10 for products used in opioid dependence

**under review**

Injection 5mg, 10mg, 30mg, 100mg, 500mg

**under review**

Tablets 30mg

For use only in patients who are breastfeeding or after initiation by the pain team.  For short term use only.

**under review**

Tablets 5mg
Injection 10mg/1mL

Methadone, when used as an analgesic, should be initiated by specialists in palliative care only

see section 4.10 for products used in opioid dependence

**under review**

Check local guidance

Check local guidance 

Oxycodone should be initiated by consultant physicians or specialists in palliative care only, it is indicated only for patients who do not tolerate morphine

**under review**

M/R tablets 50mg, 100mg, 150mg, 200mg, 250mg
 
 
for palliative care
 
 
 In Morecambe Bay for other indications

**under review**

Capsules 50mg
Dispersible tablets 50mg
m/r tablets 100mg, 200mg

 Injection 100mg/2mL