Queries from our hospices – Summer 2021

Author: Margaret Gibbs
Category: Developing your team, Pharmacy Information
Date: September 23, 2021

1. Can you put an Abstral tablet in an easy-to-open container for a patient to take when necessary?

It is not advisable to take an Abstral tablet from its packaging and store it somewhere else. The nature of the many products that are designed to dissolve easily in the mouth means they are very sensitive to the moisture in the atmosphere and become soft and unusable within hours. The scientific description is ‘hygroscopic’. Apart from the tablet becoming too soft to use, if placed in an easy-to-open container, the risk increases for anyone finding the tablet and maybe tasting or taking it. Abstral is such a potent opioid, it would be potentially lethal to someone who is not already on a background dose of 60mg morphine or equivalent in 24 hours. It is acknowledged that Abstral is packaged in a way that makes it quite a challenge to open so if prescribed to a patient at home, prescribers should ensure that the patient has the dexterity and strength to open the packaging.

2. Can we still obtain Lutrol with lidocaine?

Lidocaine 2% in Lutrol gel is a specially made product which used to be manufactured at a London hospital pharmacy. Lidocaine is mixed with Lutrol – a theromoreversible gel which sets at body temperature and stays in place well on mucous membranes. It has provided valuable analgesia to many patients with wounds in very challenging places – especially vulval cancers. It is now made at Oxford Pharmacy Store but unfortunately the price has risen hugely. It has not been available for a while but is now expected back in stock. Other products which may be helpful are lidocaine ointment or lidocaine spray but neither are as effective at staying in place as lidocaine in Lutrol.

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