The Department of Health and Social Care has issued a Medicines Supply Notification (MSN) for diamorphine 5 mg, 10 mg and 100 mg powder for solution for injection ampoules. Diamorphine 5 mg and 10 mg ampoules are out of stock with no confirmed resupply date, and 100 mg ampoules are expected to become unavailable from early January 2026.

Actions for primary care prescribers

• Do not initiate new patients on diamorphine (unless other opioid options are not considered suitable).
• Review all affected patients and switch to morphine sulfate injection (10 mg/mL) where clinically appropriate.
• Do not switch patients to 30mg strength of diamorphine as insufficient stock to support increased use.
• Morphine and diamorphine are not equipotent, and care should be taken when switching patients or amending guidelines to ensure equipotent dosage. As dose conversions are an approximate guide, it is recommended that they are carried out in consultation with specialists, with close patient monitoring after switching, and the dose titrated as needed.
• Ensure appropriate staff training to support the switch to morphine.
• Reserve remaining stock of diamorphine for patient considered unsuitable for morphine.

Please refer to the MSN guidance available via the SPS Medicines Supply Tool (requires registration and log in) for full details of required actions for primary and secondary care and considerations and background to manage the shortage.

ScriptSwitch® messages have been enabled to provide information on this shortage to support primary care.