The Pharmaceutical Journal
Vol 274 No 7336 p169
12 February 2005

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Guidance on use and supply of diamorphine

Diamorphine supplies remain low

NHS supplies of diamorphine will remain low until the end of March, the Department of Health confirmed this week.

The DoH has repeated its advice to health professionals to prescribe morphine instead and to keep any diamorphine for use in palliative care.

The drug shortage first came to light at the end of December last year and, according to the DoH, the situation has not changed.

Hospital pharmacists said this week that they still had some supplies of diamorphine which they were using as advised by the DoH and were continuing to prescribe morphine as an alternative when appropriate.

Chief pharmacist at the Whittington Hospital, London Malcolm Bubb said: “We are restricting diamorphine to palliative care patients as recommended by the chief medical officer and pretty much everybody else has been switched to morphine. Our only worry is that morphine supplies might not hold up.

“I think our diamorphine should last us up to another three weeks.”

Helen Howe, chief pharmacist at Addenbrooke’s Hospital in Cambridge, added: “We moved patients to morphine as soon as we got the advice so we do not have any stock problems at the moment, although morphine supplies have not been easy for the past year.

“One of the problems is that diamorphine is much more soluble than morphine so using morphine as an alternative can be difficult if you need to give large doses. Clinically though there is no difference between the two and we are in fact one of the few countries still offering patients diamorphine.”

A DoH spokeswoman said: “We always said that diamorphine supplies would be critical in January and February until we get further supplies at the end of March. That position has not changed.”

The NHS relies on two UK suppliers Chiron, which is its main source, and Wockhardt UK. She said: “These are the only two suppliers in the UK so we are totally reliant on them.”

The spokeswoman said the shortage of diamorphine was exceptional but that there were four morphine alternatives that can be prescribed instead. Morphine stocks were not expected to run low, she added.