For those of you that are not directly in the pharmaceutical industry or who are not healthcare providers, you may wonder why the FDA is having a meeting to discuss the morphine milligram equivalents for other opioids. Well, I know that measure gives healthcare providers a good idea of how to transition patients taking morphine in the hospital or operating room setting to other opioids in a manner that will most closely translate to the same potency and theoretical pain relief as the morphine dose they are currently receiving. In addition, it will provide a standard-reference point to determine the relative potency of all opioid products. I think the most surprising issue is that it appears that now the Agency may be questioning the original equipotent dose relationships between these older and newer therapeutic entities.
The FDA is concerned enough about the existing equivalents in the literature that it is holding a two-day meeting to discuss this topic. The public meeting, “Morphine Milligram Equivalents: Current Applications and Knowledge Gaps, Research Opportunities, and Future Directions; Public Workshop; Request for Comments,” will be held on June 7 and 8, 2021 from 9 a.m. to 5 p.m. each day. Registration is free and the webcast will be live. See the link here for more information.
This meeting has specific relevance today as the FDA has approved a variety of new and more potent opioids over the past four to five years. Bioavailability and potency may vary among products and, as the name of the meeting implies, there may be a bit of a knowledge gap between what we think we know and what is fact since many of these morphine milligram equivalent values were established years and years ago. Making sure the equivalents are correct and based on solid empirical evidence will enable practitioners to make drug product switches from morphine or other opioids in a more reliable and objectively based decision-making process.
Maybe things will stay the same or maybe they will change. The FDA wants to know your opinion! Your input is equally important for establishing an appropriate equivalence!
PLEASE NOTE THAT LINK FOR MORE INFORMATION HAS BEEN UPDATED (FDA HAS REISSUED THE FR NOTICE THAT IT REMOVED AFTER OUR INITIAL POST)