Derbyshire Medicines Management and Clinical Policies
GREEN: for second line use only - see strong opioid algorithm
Opiodur is the preferred cost-effective brand for fentanyl patch. Other brands previously recommended include Fencino, Matrifen and Mezolar which may be used if Opiodur is not suitable or not available. (Decision date - April 2023)
MHRA advice not cutting patches and avoiding exposure of patches to heat including via hot water (bath, shower). Cutting a patch is only allowed under exceptional circumstances, on advice of palliative care consultant following individualised treatment plan.
GREY after palliative care specialist initiation: all non-transdermal preparations (includes lozenges, buccal film, sublingual tablets and nasal spray) classified as GREY recognising limited use in cancer patients.
Prescribe by brand to avoid confusion. Requires specialist initiation and a titration process. Not classified as RED to allow access in primary care if needed (Decision date - May 2014)
DO NOT PRESCRIBE (DNP): all non-transdermal preparations initiated outside palliative care.
