Important information regarding the availability of diamorphine injection from EHS and H&R CCGS – this has been circulated to prescribers

A message from EHS and H&R CCGs regarding the availability of diamorphine injection – this information has been circulated to prescribers:

There is a manufacturing delay which will lead to intermittent supply issues of Diamorphine 5mg and 10mg Injection until mid-February 2018 for the 5mg and end-January for the 10mg. Feedback from community pharmacy colleagues has highlighted supply problems with the 30mg strength also.

To ensure patients do not experience delays to their treatment, when prescribing for end of life care in new patients please prescribe S/C morphine sulphate instead of diamorphine until further notice.

For new patients who  are opioid naïve, a reasonable dose of morphine would be 3.75mg to 7.5mg  S/C PRN every four hours.

Every effort should be made to avoid having to convert patients stabilised on diamorphine to morphine. Prioritising these patients for diamorphine supplies and maintaining regular communication between prescribers, patients/ carers and community pharmacies may alleviate the need to switch patients.

However, if needed, the attached conversion chart may help when converting from diamorphine S/C to morphine S/C.

Where switching is necessary, patients who already have a Drug Instruction Chart written and signed by the GP for diamorphine will need this amended, or a new chart written for morphine.

Where patients are complex or for any other advice around use of opioids please contact the local hospice for further guidance

St Michael’s Hospice 01424 445177

St Wilfrid’s Hospice 01323 434222

FOR INTERNAL ESHT – Supportive and palliative care teams Mon-Fri 0830-1600:  EDGH 07813 430421 or Conquest 07788 415014

Further communication will be sent out when the supply issue is resolved.