Modified release opioid medication
The Safe Anaesthesia Liaison Group (SALG) would like to ensure that anaesthetists are aware that prolonged release opioids are no longer licensed for the treatment of post operative pain. The use of these medications is associated with an increased risk of persistent post-operative opioid use and opioid induced ventilatory impairment. This reflects the Association of Anaesthetists guidelines on management of perioperative pain, issued September 2024 1 and a drug safety alert issued by the MHRA in March 2025.
SALG, the Faculty of Pain Medicine, the RCoA and the Centre for Perioperative Care (CPOC) sent a letter in August 2023 signed by internationally respected experts in this field to Dr Alison Cave, Chief Safety Officer at the MHRA. In this letter, we requested that the MHRA strengthen warnings around the use of modified-release opioids following strong international evidence against their use in managing acute pain. We therefore welcome the development of the drug safety alert and the accompanying public assessment report, published in March 2025 on this topic.2
- El-Boghdadly, K et al. Perioperative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society. Anaes 2024 Nov, 79(11): 1220-1236
- Medicines and Healthcare products Regulatory Agency. Drug Safety Update: Prolonged-release opioids: Removal of indication for relief of post-operative pain. March, 2025 [Accessed 10 April, 2025]