New advice on modified-release morphine

The Royal Pharmaceutical Society has reviewed its position on brand-name prescribing of modified-release morphine preparations and fentanyl patches.

The society’s practice committee decided there was no compelling evidence to show that pain control was affected by switching between brands of modified-release morphine preparations with the same release profile. 

There was also no evidence of a difference in the rate of delivery between brands of fentanyl patches when used in accordance with the product licence, says the society. 

As a result, the practice committee does not recommend routine brand name prescribing of modified-release morphine preparations and fentanyl patches. 

The committee warned that pharmacists should aim to prevent unintentional changes of the brand supplied to patients. If the brand of strong modified-release morphine preparations needs to be changed, then the pharmacist should ensure that the patient and the patient’s carers understand and accept the need for change. 

Pharmacists were also reminded: ‘There are important differences between matrix patches and reservoir patches. Reservoir patches of fentanyl should never be cut to deliver a smaller dose because this disrupts the controlled-release mechanism.’

For general enquiries contact the society’s practice and quality improvement directorate at

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