MST Continus granules to be discontinued

Alternative morphine presentations, both prolonged-release and immediate-release, remain available and will be able to support increased demand.

Anticipated out of stock dates for MST Continus granules are as follows:

• 20mg granules - November 2021
• 30mg granules - August 2021
• 60mg granules - June 2021
• 100mg granules - May 2021
• 200mg granules - January 2022

Healthcare professionals should not initiate MST Continus in new patients. Individuals currently prescribed MST Continus granules should be contacted for a treatment review.

For patients with swallowing difficulties or who are being tube fed, Zomorph (administered twice daily) and MXL capsules (administered once daily) are potential alternative modified-release morphine preparations. Further guidance can be found in the CAS alert.

When other modified-release morphine preparations are not appropriate, clinicians should consider prescribing:

• standard-release morphine preparations with as-required pain relief for breakthrough pain;
• opioid transdermal patches with as-required pain relief for breakthrough pain (in patients whose pain control has been stabilised); or
• other oral opioids (eg, oxycodone), if appropriate.

Care should be taken to ensure correct dose conversion when switching from MST Continus to standard-release morphine preparations or to alternative opioid products. Equivalence tables should be used as a guide as individual responses may vary. Patients should be monitored for signs of opioid toxicity and loss of pain control following any switch in therapy.