Shortage of Oxycodone 5mg/5ml oral solution

There is a national shortage of oxycodone oral solution 5mg/5ml in all brands.  This is expected to continue until June 2023.

Whilst some limited stock is available this will quickly run out. The following suggestions should help manage patients during this time.

GP surgeries are asked to:

• Consider Morphine as first line for the majority of patients
• Reduce dose and/or reduce frequency in renal impairment or if the patient experiences sedation or hallucinations with morphine
• Switch opioids only if there is significant renal impairment and sedation/delirium with morphine

For patients requiring an immediate release Oxycodone for breakthrough pain GP surgeries should regularly review to optimise background dose and reduce any breakthrough requirement

Ist line treatment doses of 5mg and above:

• Prescribe capsules. Capsules may be opened and mixed with water or soft cool food if swallowing difficult.
• Oxycodone capsules: 5mg, 10mg and 20mg available.
• Prescribe generically to maximise supply chain.

2^nd line treatment for doses less than 5mg

• Consider using morphine oral solution 10mg/5ml for breakthrough only.Conversion is oxycodone:morphine 1:2 e.g. 3mg oxycodone PRN = 6mg morphine sulphate PRN (can give 5mg for ease of measuring)

3^rd line treatment

• Switch to Oxycodone CONCENTRATED oral solution 10mg/ml. Use of concentrate will require patient education due to small volumes and high risk.

Please refer prescribers to this information if you need to speak to a surgery to get a prescription changed.