Zomorph® - Preferred Brand Oral Morphine M/R in Adults
MST® is currently the most frequently prescribed brand of morphine sulphate modified release (M/R) across NHSGGC. From 01/09/2017 the preferred choice of solid morphine sulphate M/R across primary and secondary care will change to Zomorph® capsules.
As Zomorph® is not licensed for use in children this change applies to adults only. It is not proposed to change patients prescribed MST® sachets to Zomorph® capsules at present.
Patients on MST Continus® tablets and Morphgesic® tablets can be safely switched to Zomorph® capsules at the same dose and frequency as the brands are considered therapeutically equivalent. No loss in pain control is expected.
Zomorph® capsules are available in the same range of strengths as MST Continus® and Morphgesic® tablets with the exception of 5mg and 15mg strengths. If these strengths are required MST® tablets can continue to be prescribed.
NHSGGC recommend that, unless there are clinical or patient reasons suggesting otherwise, Zomorph® capsules should be prescribed by all clinicians from 1st September 2017 in all care settings including hospices.
Palliative care and chronic pain teams are aware of this change.
Those involved in prescribing, dispensing, and recording stocks of controlled drugs are asked to remember the following points:
- Modified-release preparations of controlled drugs should be prescribed by brand name.
- It is a legal requirement to specify the formulation of the product in any prescription for a controlled drug i.e. the word “capsule” must be clearly stated on Zomorph® prescriptions.
Primary Care Implementation
- Community pharmacists have been notified of a likely reduction in prescribing of MST® and to monitor demand and adjust stock levels of products accordingly.
- Prescribers in primary care will be made aware of this recommendation via a ScriptSwitch message.
- Prescribing support staff will be encouraged to support active switching to Zomorph® in GP practices from September 2017 onwards.
Secondary Care Implementation
Prescribers in secondary care will receive a memo advising them of this change in practice. Zomorph® capsules will be supplied against all ward orders for morphine sulphate M/R tablets in acute care as soon as existing stocks of MST Continus® are depleted. All discharge prescriptions for solid morphine sulphate M/R should be for Zomorph® capsules unless an alternative formulation is specifically requested with rationale.