Why does the BNF not recommend brand-name prescribing of modified-release opioids?
The BNF has not seen any evidence to indicate that switching between brands of modified-release opioids that have the same release profile (e.g. between different brands of 12-hourly oral morphine, or between different brands of fentanyl patch) alters the therapeutic effect. Furthermore, when used in accordance with the product licence, there are no grounds for a clinical difference between brands of fentanyl patch. A suggestion has been made that brand-name prescribing of opioids should be adopted on grounds of safety. However, the BNF is not clear why modified-release opioids should be treated differently to other drugs commonly associated with medication errors (e.g. carbamazepine), or, indeed, other drugs in general. We have not seen any evidence to show that brand-name prescribing of modified-release opioids would have a significant impact on the incidence of medication errors associated with these preparations—if users of the BNF know of such evidence, we would be pleased to cons
