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.