Potential risk of error in selecting incorrect oxycodone strength

10 Apr 2015

Incidents involving the selection of the wrong strength of oxycodone oral solution by the prescriber has been reported. Oxycodone oral solution 10mg/ml has been selected instead of oxycodone oral solution 5mg/ml which has led to two patients requiring hospital treatment.

Reports of incidents involving the selection of the wrong strength of oxycodone oral solution by the prescriber have been highlighted by a Controlled Drug Accountable Officer.

Oxycodone oral solution 10mg/ml appears as the first option on Egton Medical Information Systems (EMIS) used by GP surgeries, and has been picked instead of oxycodone oral solution 5mg/5ml. This error appears to have led to two patients needing hospital treatment.

Pharmacists should make sure they check all prescriptions for oxycodone oral solution 10mg/ml and confirm with the prescriber that it is the intended strength.

For further information on this or any other query, please contact the NPA Pharmacy Services Team on 01727 891 800 / 0844 736 4201 or email pharmacyservices@npa.co.uk .

Produced by the NPA Pharmacy Services Team April 2015.