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.