• 250mg and 500mg tablets
• Oral suspension and effervescent tablets available 
• No evidence for GI benefit of EC preparation - use standard tablets.

•   for cancer patients (rest of Wiltshire and Swindon)
•  Amber for cancer patients BaNES
• M/R Tablets 5mg, 10mg, 20mg, 40mg, 60mg, 80mg Longtec^®. Prescribe by brand.
• For the treatment of moderate to severe pain in patients with cancer pain.
• Oxycodone may be initiated in preference to morphine for the management of pain by a GP with experience in palliative care or on the advice of the palliative care team or pain team when: Dose escalation with morphine is not possible due to opioid toxicity eg. hallucinations, myoclonic jerks and confusion.

  for cancer patients (rest of Wiltshire and Swindon)

 Amber for cancer patients BaNES

• Tablets 5mg, 10mg, 20mg, Shortec^®.
• Oral solution 5mg/5ml, or concentrate 10mg/ml
• Prescribe by brand.
• Oxycodone may be initiated in preference to morphine for the management of pain by a GP with experience in palliative care or on the advice of the palliative care team or pain team. 

• Tablet 15mg, 30mg, 60mg
• Useful for the relief of mild to moderate pain but is too constipating for long-term use

• Patch 35 microgram/ hour, for 4 days
• Patch 52.5 microgram/ hour, for 4 days
• Patch 70 microgram/ hour, for 4 days
• Only to be used in patients with cognitive deficit or swallowing difficulties, after a trial of soluble/liquid medication. Zomorph capsules can be opened for ease of swallowing.
• Buprenorphine patches are not suitable for management of acute / intermittent pain.
• Patients and/or their carers need to be aware that these patches need to be applied at appropriate 96 hour intervals (or 4 days). Remember to remove the old patch before application of new patch. Avoid use of multiple patches.

• 7 day patch of choice for consistency and safety
• Patch 5 microgram/hour for 7 days 
• Patch 10 microgram/hour for 7 days
• Patch 15 micrograms/hour for 7 days
• Patch 20 microgram/hour for 7 days
• Only to be used in patients with cognitive deficit or swallowing difficulties, after a trial of soluble/liquid medication. Zomorph capsules can be opened up for ease of swallowing.
• Buprenorphine patches are NOT suitable, or licensed, for management of acute / intermittent pain.
• Patients and/or their carers neeed to be aware that these patches need to be applied at appropriate seven-day intervals. Remember to remove the old patch before application of new patch. Avoid use of multiple patches.

• Capsules 50mg
• Soluble tablets 50mg
• Modified release MR capsules (limited use)
• Schedule 3 CD with exemption from safe custody requirements

• Patch 12 microgram/hour, for 3 days
• Patch 25 microgram/hour, for 3 days
• Patch 50 microgram/hour, for 3 days
• Patch 75 microgram/hour, for 3 days
• Patch 100 microgram/hour, for 3 day
• Fentanyl patches are only licensed for chronic intractable pain. For palliative care use.
• Fentanyl patches are not suitable for use in the management of acute / intermittent pain.
• Oral morphine 90mg over 24 hours is equivalent to one ’25 micrograms/hour’ patch.  
• Only to be used in patients who require equivalent dose of at least 60mg morphine daily
• Fentanyl is available both as a reservoir patch and a matrix patch (do not cut either)
• Patients and/or their carers need to be aware that fentanyl patches need to be applied at appropriate 72-hour (three-day) intervals. Remember to remove the old patch before application of new patch

• Buccal tablets 100 micrograms, 200 micrograms, 400 micrograms, 600 micrograms, 800 micrograms
• Breakthrough cancer pain for patients in whom oral morphine sulphate solution is inappropriate.  Under the recommendation of a palliative care specialist only.
• NOT approved for non cancer pain
• Patients must be assessed by the palliative care or pain team before commencing treatment. They should be used in the minority of patients with breakthrough pain that fail immediate release morphine or oxycodone. Review weekly.  
• Prescribe by brand name to ensure that the correct product is dispensed.

• 100micrograms/dose, 400micrograms/dose
• Breakthrough cancer pain for patients in whom oral morphine sulphate solution is inappropriate.  Under the recommendation of a palliative care specialist only.
• NOT approved for non cancer pain 

• Tablets 5mg 
• Oral Solution 1mg/ml
• Only on recommendation of palliative care specialist

• 100mcg, 200mcg, 300mcg, 400mcg, 600mcg, 800mcg sublingual tablet
• Palliative care or pain specialist initiation only
• Patients must be assessed by the palliative care or pain team before commencing treatment. They should be used in the minority of patients with breakthrough pain that fail immediate release morphine or oxycodone. Review weekly.

• Capsules 30mg, 60mg
• For the treatment of neuropathic pain

• Capsules 25mg, 50mg, 75mg, 100mg, 150mg, 225mg, 200mg, 300mg
• Note pregabalin tablets are not included on the BSWformulary
• For neuropathic pain

• Capsules 100mg, 300mg, 400mg 

• Tablets 10mg, 25mg
• 'Off label' use for neuropathic pain
• Should only be used if amitriptyline isn't tolerated or is contra indicated

• 250mg and 500mg tablets
• Oral suspension and effervescent tablets available 
• No evidence for GI benefit of EC preparation - use standard tablets.

• For specific indications
• Tablets 500 microgram, 2mg

• Tablets 2mg, 5mg, 10mg
• Oral Solution 2mg in 5ml,

• Can be used as per Palliative Care specialist recommendation (off-label)  on a case by case basis between specialist and GP. Locally agreed indication (August 2019).
• For all other indications see entry under neuropathic pain 04.07.03
• Medicated plasters lidocaine 5%. Prescribe by the brand name: Ralvo^®

• 800 micrograms/ml, 5ml (4mg) vial
• Prevention of skeletal related events (pathological fractures, spinal compression, radiation or surgery to bone, or tumour-induced hypercalcaemia) in adult patients with advanced malignancies involving bone. 
• Treatment of adult patients with tumour-induced hypercalcaemia (TIH).

• Tablet 50mg

• Tablet 10mg
• Suspension 5mg in 5ml
• Domperidone should be used at the lowest effective dose for the shortest possible duration

• Tablets 500 micrograms, 1.5mg, 5mg, 10mg
• Oral liquid^SF 1mg in 1ml

• 25mg Tablets (NB 6mg tablets are unlicensed and Non Formulary)
• For palliative care for the management of pain, associated restlessness, distress or vomiting

• Tablet 10mg
• Syrup 5mg in 5ml
• Metoclopramide and prochlorperazine are associated with a high risk of dystonias and oculogyric crises particularly in children, young adults and elderly. 
• Severe reactions to metoclopramide should be treated with procyclidine injection

• Tablet 4mg, 8mg
• Syrup^SF 4mg in 5ml

• Tablet 5mg
• Syrup 5mg in 5ml
• Buccal tablet 3mg (as an alternative to injection in Primary Care)
• Notes: Severe reactions to prochlorperazine should be treated with procyclidine injection, Prochlorperazine should not be prescribed for patients with Parkinson's & should be used with caution in the elderly.

• Orodispersible tablet (Velotab^®) 5mg
• For Nausea and Vomiting

• 10mg tablets. 

• 150mcg tablet
• 300mcg sublingual tablets
• Scopoderm^® TTS Patch 1mg/ 72hrs

• Tablets 2mg, 5mg, 10mg
• Oral Solution 2mg in 5ml,

• Tablets 1mg
• Can be given subligually (off label) 
• Not all brands of lorazepam can be absorbed sublingually. Please use Genus, Metwest and Genesis brands

• Epistatus^® Oromucosal solution prefilled single syringe 10mg/1ml 
• Epistatus^® Oromucosal solution 10mg/ml prefilled syringes: 2.5mg/0.25ml, 5mg/0.5ml, 7.5mg/0.75ml, (unlicensed).  Individually wrapped in a pack of 4.
• Prescribe by BRAND (NB Buccolam brand is a different salt, STRENGTH and volume) 
• In the palliative care setting PRN use only

• 12.5mg & 25mg tablets.
• Please note: This may be considered as an option for treatment of opioid- induced constipation in adults, whose constipation has failed to adequately respond to laxatives appropriately escalated in accordance with our BSW Guidance on the Management of Constipation in Adults (2018), and in whom stopping opiates would be clinically inappropriate.

• 12 mg/0.6 mL
• Opioid induced constipation in terminal illness when response to other laxatives inadequate.
• Formulary status under review

• Oxetacaine 10mg/5ml with aluminium and magnesium hydroxides Suspension
• For palliative care use