Morphine Sulfate Injection BP 30 mg in 1 mL ampoule is not safe to be used for either the epidural or intrathecal routes.
Morphine Sulfate Injection BP 30 mg in 1 mL ampoule is an unregistered product (sourced from overseas) that has been approved for use as an alternative product during the current shortage of DBL Morphine Sulfate 30 mg/1 mL injection BP ampoule.
DBL Morphine Sulfate 30 mg/1 mL injection BP ampoule is the only registered morphine 30 mg injection product marketed in Australia and is not expected to be available again until 30 May 2019.
In the meantime, the TGA has granted approval under Section 19A of the Therapeutic Goods Act 1989 to Link Medical Products to supply the alternative product, Morphine Sulfate Injection BP 30 mg in 1 mL ampoule, for the following indication:
- For the relief of severe pain not responsive to non-opioid analgesics.
While Morphine Sulfate Injection BP 30 mg in 1 mL ampoule is a suitable alternative in most situations, there are critical formulation differences between it and the registered product that have potential patient safety implications.
Morphine Sulfate Injection BP 30 mg in 1 mL ampoule contains preservative (unlike the DBL morphine product) which means it can only be administered intravenously, intramuscularly or subcutaneously.
Although DBL Morphine Sulfate 30 mg/1 mL injection has not been approved for use by the epidural or intrathecal routes, and references only intravenous, intramuscular and subcutaneous routes in its Product Information, the TGA is aware that there is some off-label use via the other two routes.
Below is a picture of the labelling for the Section 19A-approved product which includes an oversticker with a warning about this issue.
Information for consumers
If you have any questions or concerns about this issue, talk to your health professional.
Information for health professionals
Link Medical Products has distributed a Dear Health Care Professional Letter (pdf,179kb)
