Do Not Prescribe (DNP), Grey - after consultant/specialist initiation, Green
Decision Date:
March 2011


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.                  

Grey Drug Classifications

  • 5: Less cost-effective than current standard therapy

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Derby and Derbyshire ICB

Derby and Derbyshire ICB

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