Pharmacy leaders have warned GPs that they may have to switch their patients on diamorphine to a different treatment due to a shortage.
The NHS Specialist Pharmacy Service has alerted clinicians through an NHS shortage alert that one of the two manufacturers of diamorphine injections for the UK ‘are experiencing issues at their manufacturing site which supplies the 5mg and 10mg injections’.
It said that GPs therefore must assess which alternative opioid analgesic is most appropriate for each individual patient, and take care when switching from one medication to another to ensure the correct dosage.
Higher strengths of diamorphine injections, such as the 100mg and 500mg, have not been affected by this issue.
The alert said: ‘As there are alternative opioid analgesics to diamorphine, in particular morphine, clinicians will need to decide which product is most appropriate for each individual patient.
‘Care is needed when switching from one opioid analgesic to another to ensure equipotent dosage.’
It added that patients should be carefully monitored after any drug switch.
NHS England has also alerted partients to the shortage. It said: ‘Continue to take your medication as your doctor or pharmacist has advised you to.
‘When you need a new prescription or repeat prescription your doctor or pharmacist will talk to you about whether you will be prescribed a similar drug. If you are prescribed morphine you will be closely monitored by your healthcare professional or support worker.’
NHS Specialist Pharmacy Service has told clinicians to refer to local guidance, the BNF or the palliative care formulary for information on dose conversion to other opioids, and to contact relevant specialist teams for advice on management of individual cases.