Long acting opioids 50mg to 119mg per day OME
- Coding system
- Pseudo BNF
- Coding system release
- 86 (2024-01-01)
- Organisation
- OpenSAFELY
- Codelist ID
- opensafely/long-acting-opioids-50mg-to-119mg-per-day-ome
- Version ID
- 74114984
Versions
- 74114984
Description
User requirements
A codelist is needed of all long acting opioids with an oral morphine equivalence (OME) of 50-119mg per day - used for analgesia (any route) excluding cough suppression, motility, general anaesthesia, opiate use disorder - this is for a project looking at opioid prescribing for patients on hospital waiting lists.
Sensitivity versus specificity
Any opioid as a modified release formulation or transdermal patch with daily OME 50-119mg based on standard dosing.
Relevant definitions or links to important reference sources
Opioid equivalence - https://fpm.ac.uk/opioids-aware-structured-approach-opioid-prescribing/dose-equivalents-and-changing-opioids
Existing relevant codelists
Nil
Methodology
Search terms / synonyms / search strategy
BigQuery used to identify relevant products from BNF data. dm+d data used to filter for modified release/patch versions as appropriate. Faculty of Pain Medicine OME conversions used to calculate daily OME - usual licensed dosing used to determine OME (for example morphine sulphate MR products licensed for twice a day administration (with exception of MXL) - so if prescribed 60mg tablet assume taking twice a day (120mg / day total) - or for MXL assume taking once a day so would be prescribed 120mg tablet to meet 120mg/day total.
SELECT DISTINCT presentation_code as code, presentation as term
FROM hscic.bnf p
INNER JOIN dmd.vmp vmp ON CONCAT(SUBSTR(p.presentation_code,0,9),'AA', SUBSTR(p.presentation_code,-2), SUBSTR(p.presentation_code,-2)) = vmp.bnf_code
INNER JOIN dmd.vpi AS vpi ON vmp.id = vpi.vmp
INNER JOIN dmd.ont AS ont ON vmp.id = ont.vmp
INNER JOIN dmd.ontformroute AS route ON ont.form = route.cd
WHERE
((vpi.ing = (60886004) AND route.descr LIKE '%modified-release.oral' AND p.presentation NOT LIKE '%MXL%' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=25 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <60) /* Morphine Sulfate MR oral preps [excluding MXL as 24hr] (ing code) */
OR (vpi.ing = (60886004) AND route.descr LIKE '%modified-release.oral' AND p.presentation LIKE '%MXL%' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=50 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <120) /* MXL (24hr release) (ing code) */
OR (vpi.ing = 387024006 AND route.descr LIKE '%modified-release.oral' AND p.presentation NOT LIKE '%Onexila%' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=17 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <40) /* Oxycodone MR oral preps [excluding Onexila as 24hr] (ing code) */
OR (vpi.ing = 387024006 AND route.descr LIKE '%modified-release.oral' AND p.presentation LIKE '%Onexila%' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=33 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <80) /* Onexila MR (24hr release) (ing code) */
OR (vpi.ing IN (442699004,441757005,40755011000001109) AND route.descr LIKE '%modified-release.oral' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=63 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <150) /* Tapentadol HCl/Phosphate MR oral preps (ing code) */
OR (vpi.ing IN (386858008, 108505002) AND route.descr LIKE '%modified-release.oral' AND (p.presentation NOT LIKE '%Tradorec XL%' AND p.presentation NOT LIKE '%Zamadol 24hr%' AND p.presentation NOT LIKE '%Zydol XL%' AND p.presentation NOT LIKE '%Dromadol XL%') AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=250 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <600) /* Tramadol HCl/ Tramadol MR 12 hour oral preps (ing code) */
OR (vpi.ing IN (386858008, 108505002) AND route.descr LIKE '%modified-release.oral' AND (p.presentation LIKE '%Tradorec XL%' OR p.presentation LIKE '%Zamadol 24hr%' OR p.presentation LIKE '%Zydol XL%' OR p.presentation LIKE '%Dromadol XL%') AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=500 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <1200) /* Tramadol HCl/ Tramadol MR 24 hour oral preps (ing code) */
OR (vpi.ing IN (44508008, 387485001) AND route.descr LIKE '%modified-release.oral' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=5 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <12) /* Hydromorphone (ing code) */
OR (vpi.ing IN (322538006, 387322000) AND route.descr LIKE '%modified-release.oral' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=250 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <600) /* Dihydrocodeine (ing code) */
OR (vpi.ing = (387173000) AND route.descr LIKE 'patch.transdermal' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >20 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <52) /* Buprenorphine patches (ing code) */
OR (vpi.ing = 373492002 AND route.descr = 'patch.transdermal' AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) >=25 AND strnt_nmrtr_val/(COALESCE(strnt_dnmtr_val,1)) <50)) /* Fentanyl patches (ing code) */
GROUP BY code, term
Inclusion criteria for codes
Any modified release or transdermal opioid with daily OME 50-119mg (based on licensed dosing).
Exclusion criteria for codes
NA
Borderline cases
NA
References
Signed off by
- Chris Wood, (Feb. 6, 2024)
- Vicky Speed, (Feb. 6, 2024)
Codelists are developed by a broad community of users for individual study purposes, which may or may not meet the needs of other studies. They should not be thought of as universal definitions of a particular condition.
We don't offer any guarantees about what they do or don't identify. Users should carefully check that any codelist meets their needs, and seek clinical input where appropriate.
code | term |
---|---|
040702040AAAMAM | Tramadol 300mg modified-release tablets |
040702040AAANAN | Tramadol 400mg modified-release tablets |
040702050AAACAC | Hydromorphone 8mg modified-release capsules |
040702050BBAEAC | Palladone SR 8mg capsules |
0407020A0AAAEAE | Fentanyl 25micrograms/hour transdermal patches |
0407020A0AABWBW | Fentanyl 37.5microgram/hour transdermal patches |
0407020A0BBAAAE | Durogesic 25micrograms transdermal patches |
0407020A0BBAIAE | Durogesic DTrans 25micrograms/hour transdermal patches |
0407020A0BDAAAE | Tilofyl 25micrograms/hour transdermal patches |
0407020A0BEABAE | Matrifen 25micrograms/hour transdermal patches |
0407020A0BFABAE | Mezolar Matrix 25micrograms/hour transdermal patches |
0407020A0BFAFBW | Mezolar Matrix 37.5microgram/hour transdermal patches |
0407020A0BGAAAE | Fentalis Reservoir 25micrograms/hour transdermal patches |
0407020A0BHAAAE | Osmach 25micrograms/hour transdermal patches |
0407020A0BLAAAE | Osmanil 25micrograms/hour transdermal patches |
0407020A0BMAAAE | Victanyl 25micrograms/hour transdermal patches |
0407020A0BQABAE | Fencino 25micrograms/hour transdermal patches |
0407020A0BRABAE | Opiodur 25micrograms/hour transdermal patches (Pfizer) |
0407020A0BRAGAE | Opiodur 25micrograms/hour transdermal patches (RX Farma) |
0407020A0BRALAE | Opiodur 25micrograms/hour transdermal patches (Zentiva) |
0407020A0BUABAE | Mylafent 25micrograms/hour transdermal patches |
0407020A0BVABAE | Yemex 25micrograms/hour transdermal patches |
0407020ADAAAGAG | Oxycodone 20mg modified-release tablets |
0407020ADAAARAR | Oxycodone 30mg modified-release tablets |
0407020ADBCABAG | OxyContin 20mg modified-release tablets |
0407020ADBCAHAR | OxyContin 30mg modified-release tablets |
0407020ADBDACAG | Carexil 20mg modified-release tablets |
0407020ADBEACAG | Longtec 20mg modified-release tablets |
0407020ADBEAHAR | Longtec 30mg modified-release tablets |
0407020ADBFACAG | Oxylan 20mg modified-release tablets (Chanelle Medical) |
0407020ADBFAHAG | Oxylan 20mg modified-release tablets (Actavis) |
0407020ADBGABAG | Candox 20mg modified-release tablets |
0407020ADBIAAAG | Dolocodon PR 20mg tablets |
0407020ADBKACAG | Reltebon 20mg modified-release tablets |
0407020ADBKAGAR | Reltebon 30mg modified-release tablets |
0407020ADBLACAR | Oxeltra 30mg modified-release tablets |
0407020ADBLAHAG | Oxeltra 20mg modified-release tablets |
0407020ADBMADAG | Abtard 20mg modified-release tablets |
0407020ADBMAFAR | Abtard 30mg modified-release tablets |
0407020ADBNAEAG | Zomestine 20mg modified-release tablets |
0407020ADBPACAG | Leveraxo 20mg modified-release tablets |
0407020ADBPADAR | Leveraxo 30mg modified-release tablets |
0407020ADBQACAH | Onexila XL 40mg tablets |
0407020ADBRADAG | Renocontin 20mg modified-release tablets |
0407020ADBRAEAR | Renocontin 30mg modified-release tablets |
0407020ADBSADAG | Oxypro 20mg modified-release tablets |
0407020ADBSAEAR | Oxypro 30mg modified-release tablets |
0407020ADBTADAG | Ixyldone 20mg modified-release tablets |
0407020ADBTAEAR | Ixyldone 30mg modified-release tablets |
0407020AFAAABAB | Oxycodone 20mg / Naloxone 10mg modified-release tablets |
0407020AFBBABAB | Targinact 20mg/10mg modified-release tablets |
0407020AFBCABAB | Myloxifin 20mg/10mg modified-release tablets |
0407020AFBDACAB | Oxyargin 20mg/10mg modified-release tablets |
0407020AGAAADAD | Tapentadol 100mg modified-release tablets |
0407020AGBBADAD | Palexia SR 100mg tablets |
0407020AGBCACAD | Ationdo SR 100mg tablets |
0407020AHAAABAB | Tapentadol 100mg modified-release capsules |
0407020AHBBABAB | Tapimio 100mg modified-release capsules |
0407020B0AAAEAE | Buprenorphine 35micrograms/hour transdermal patches |
0407020B0BDAAAE | Transtec 35micrograms/hour transdermal patches |
0407020B0BGAAAE | Hapoctasin 35micrograms/hour transdermal patches |
0407020B0BIAAAE | Bupeaze 35micrograms/hour transdermal patches |
0407020B0BJAAAE | Prenotrix 35micrograms/hour transdermal patches |
0407020B0BNAAAE | Buplast 35micrograms/hour transdermal patches |
0407020B0BPAAAE | Relevtec 35micrograms/hour transdermal patches |
0407020B0BSAAAE | Turgeon 35micrograms/hour transdermal patches |
0407020B0BTAAAE | Carlosafine 35micrograms/hour transdermal patches |
0407020Q0AAALAL | Morphine 30mg modified-release tablets |
0407020Q0AACPCP | Morphine 30mg modified-release granules sachets sugar free |
0407020Q0AAEAEA | Morphine 50mg modified-release capsules |
0407020Q0AAEGEG | Morphine 30mg modified-release capsules |
0407020Q0BBABAL | MST Continus 30mg tablets |
0407020Q0BBAGCP | MST Continus suspension 30mg granules sachets |
0407020Q0BIABEH | MXL 60mg capsules |
0407020Q0BIACDU | MXL 90mg capsules |
0407020Q0BJABEA | Morcap SR 50mg capsules |
0407020Q0BKABEG | Zomorph 30mg modified-release capsules |
0407020Q0BMABAL | Filnarine SR 30mg tablets |
0407020Q0BNABAL | Morphgesic SR 30mg tablets |
0407020Q0BPABAL | Rhotard Morphine SR 30mg tablets |
Codes not in the full codelist are in faint grey.