Morphine oral liquid: Supply issue

Last Updated: 3 October 2024

Supply issue Active

There is a New Zealand wide shortage of morphine oral liquid.

On this page

3 October 2024 | Update

Juno, the supplier, advises that RA-Morph 5 mg per ml is now back in stock. Stock of the 1 mg per ml and 5 mg per ml strengths is available from wholesalers. Pharmacists, please check with your wholesaler about availability.

Oramorph 2 mg per ml (Medsafe-registered Pharmacode 2675048) is still available to cover the 2 mg per ml presentation. Noting, that it may not be suitable for some people because it contains alcohol.

Supply situation

Morphine oral liquid is available. RA-Morph is starting to be supplied again in New Zealand. Currently the 1 mg / ml strength and 5 mg / ml are available and other strengths will become available throughout 2024.

Alternative brands

Oramorph 2 mg / ml remains available (Pharmacode: 2675048). It is Medsafe-approved.

Schedule listing for Oramorph(external link)

Oramorph is slightly different from the RA-Morph brand.

Oramorph oral liquid morphine differences

Important differences from the RA-Morph brand:

Labelled 10 mg per 5 ml (equivalent to 2 mg per ml)
Different morphine salt (sulphate instead of hydrochloride)
Contains alcohol (ethanol) 10%v/v as a preservative
Colourless to pale yellow

Morphine salt

We’ve received clinical advice that the salts are interchangeable and have no impact on the equivalent dose of morphine.

Alcohol content

The alcohol content in 5 ml of Oramorph is equivalent to 10 ml beer or 4 ml wine.

We are aware this could present issues for use for certain groups of people including children, pregnant or breastfeeding women, and people recovering from Alcohol Use Disorder or dependency.

We suggest anyone with concerns about this speak with their prescriber or pharmacist.

People using morphine oral liquid

Expect different brands

If you have previously used morphine oral liquid, you will get different brands than you are used to. Please talk to pharmacist about what these changes mean for you.

You may also need a new prescription.

Healthify have developed some guidance for people who take morphine oral liquid.

Wockhardt and Oramorph oral liquid morphine - patient flyer - March 2024 [PDF, 181 KB]

We apologise

We know that supply issues can be disruptive and we apologise for any problems that this issue might cause.

We continue to work to reduce the effect of this supply issue on people who use morphine oral liquid.

Prescriber information

The different morphine salts are interchangeable

Clinical advice states that the different salts of morphine (sulphate compared to hydrochloride) are interchangeable and have no impact on the equivalent dose of morphine. RA-Morph contains the morphine hydrochloride salt and Oramorph contains morphine sulphate salt.

Alcohol in Oramorph

Oramorph contains alcohol (ethanol) 10% v/v as a preservative. The alcohol content in 5 ml of Oramorph is equivalent to 10 ml beer or 4 ml wine. The datasheet for Oramorph outlines that this is not likely to have an effect in adults and adolescents, and its effects in children are not likely to be noticeable. However please counsel affected individuals about this.

Health care professional resources

Pharmacist information

Strength changes

Please counsel affected people and their whānau and caregivers on the strength of morphine oral liquid that they are receiving and the dose they need to use.

Please take extra care with the different labelling of the strength of the alternate brands. Strengths of the Oramorph brand is labelled as per 5 ml, whereas RA-Morph is labelled as per 1 ml.

Healthify has developed this flyer to support your discussions with patients.

Wockhardt and Oramorph oral liquid morphine - patient flyer - March 2024 [PDF, 181 KB]

Caution stickers

Caution alert stickers are available to order for free from PharmacOnline (under the miscellaneous category). You may need to refresh the web page.

Order stickers from PharmacOnline(external link) (Use the "Public User" button)

Resupply underway

We are working closely with a supplier, LumaCina, to re-introduce the RA-Morph brand. LumaCina took over the Australian manufacturing plant where RA-Morph was made.

LumaCina, Medsafe, and Pharmac have been working together to get RA-Morph back in Aotearoa New Zealand this year.

The 1 mg/ml strength and 5 mg/ml strengths are available now, the other strengths will arrive later in 2024.

Datasheet for RA-Morph sponsored by LumaCina – Medsafe [PDF](external link)

Who to contact

If you have questions about morphine oral liquid, please email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.