Debated in Parliament on 26 Jul 2021.
Dr Tan Wu Meng asked the Minister for Health with regard to oral morphine syrup used to treat patients with pain and breathlessness (a) why have certain batches been procured with different concentration and formulation containing 10% ethanol; (b) what is done to minimise error risk from different medication concentrations especially when administered by care-givers at home; and (c) for patients uncomfortable with ethanol-containing medication, what has been done to help patients access ethanol-free alternatives.
The only registered Oral Morphine one milligram per millilitre (1mg/ml) Syrup (Statex) in Singapore was discontinued in 2019 as the plant ceased manufacturing the product. The Agency for Logistics and Procurement Services (ALPS) then brought in Oramorph 2mg/mL syrup, which contains Ethanol, for use in public healthcare institutions (PHIs). This was the only alternative that we were able to source for at that time.
Doctors were advised to offer non-alcohol based medications with the same analgesic effect instead of oral morphine solutions for their patients who could not take ethanol containing medication. ALPS has since procured a non-ethanol containing morphine syrup, Ra-morph 1 mg/ml preparation for the PHIs.
Each preparation is clearly labelled with the formulation and dosage instructions. Doctors, pharmacists and nurses work together to educate patients and caregivers on the differences in the medications and help them to switch from one formulation to another, when necessary.
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