MHRA Removes Indication for Prolonged-Release Opioids in Post-Operative Pain Management
The Medicines and Healthcare products Regulatory Agency (MHRA) has updated its guidance on the use of prolonged-release opioids, removing their indication for the treatment of post-operative pain relief. This decision follows concerns about delayed onset of analgesia, overdose risk, and inappropriate prescribing in acute settings.
Introduction:
Opioids are widely used for pain management, but their prolonged-release formulations are not designed for acute post-operative pain, where rapid pain relief is often required. The MHRA’s latest guidance advises against their use in this context, citing safety risks such as delayed onset of action leading to overdose, inappropriate prescribing, and prolonged opioid dependence.
Key Changes in Guidance:
The updated MHRA guidance states that prolonged-release opioids should no longer be prescribed for post-operative pain relief. Instead, immediate-release formulations should be used where opioid therapy is necessary. The decision is based on the risk of delayed analgesic effects, which can lead to accidental overdose if patients take additional doses due to inadequate pain relief.
Additionally, the removal of this indication aims to reduce the risk of long-term opioid dependence, as prolonged-release opioids are intended for chronic pain management, not short-term post-operative use.
Implications for Clinical Practice:
Healthcare professionals should review their post-operative pain management protocols to ensure that prolonged-release opioids are not prescribed inappropriately. Instead, immediate-release opioids, non-opioid analgesics, and multimodal pain relief strategies should be considered as alternatives.
For patients who have already been prescribed prolonged-release opioids post-operatively, clinicians should assess ongoing need, consider deprescribing where appropriate, and ensure safe tapering protocols are in place to avoid withdrawal effects.
Conclusion:
The MHRA’s decision to remove the indication of prolonged-release opioids for post-operative pain relief is a step towards safer prescribing practices and improved patient outcomes. Clinicians should update prescribing protocols accordingly, ensuring that opioid therapy is used appropriately and safely in post-surgical care.
Citation:
Medicines and Healthcare products Regulatory Agency. Prolonged-Release Opioids: Removal of Indication for Relief of Post-Operative Pain
Read more: Prolonged-release opioids: Removal of indication for relief of post-operative pain
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