Prescribing Tip No. 30 Date: 4th June 2014 Tramadol reclassified as Schedule 3 Controlled Drug Tramadol is currently a Prescription Only Medicine (POM). From the 10th June 2014 it will become a Schedule 3 Controlled Drug in England, Wales and Scotland. Controlled Drug prescription requirements will apply but it will be exempt from safe custody requirements. The restriction on tramadol prescribing comes after the Home Office accepted advice from the Advisory Council on the Misuse of Drugs (ACMD) that the drug should become controlled as a class C drug and placed in schedule 3 of the 2001 regulations on drugs misuse. This follows a spate of deaths linked to ‘recreational use’ of tramadol: recorded deaths involving the analgesic have almost doubled from 83 in 2008 to 154 in 2011. The move will make the classification of tramadol consistent with the scheduling of other opioids used in the treatment of moderate to severe pain. Prescribers are reminded schedule 3 prescription requirements include: • the prescription must be indelible - a computer generated prescription is acceptable but the prescriber’s signature must be handwritten. • as with all prescriptions, Schedule 3 prescriptions must be signed by the prescriber and contain a date and the prescriber’s address. • in general, prescriptions for schedule 3 controlled drugs should be limited to a supply of 30 days treatment. The prescription must always state: • the name and address of the patient. • the form and where appropriate the strength of the preparation. • the total quantity in both words and figures of the preparation. • the dose – the instruction ‘one as directed’ constitutes a dose but ‘ as directed’ does not. NB. A prescription for a controlled drug is valid for 28 days from the date of issue. Batch repeat dispensing, faxed prescriptions and emergency supplies are not permitted for Schedule 3 controlled drugs. Practices are reminded to check all prescriptions for tramadol generated after 10th June 2014 for correct prescription requirements to avoid prescriptions being returned by Pharmacists. http://www.mhra.gov.uk/Howweregulate/Medicines/Medicinesregulatorynews/CON421308 To contact the Medicines Optimisation team please phone 01772 214302 or 01695 588014