Prescription medicines that present the greatest risk of harm for the Victorian community are monitored through SafeScript.

Medicines monitored in SafeScript include:

Strong opioid painkillers

Buprenorphine, Codeine, Fentanyl, Hydromorphone, Methadone, Morphine, Oxycodone, Pethidine, Tapentadol.

Strong medicines for anxiety or sleeping tablets (benzodiazepines)

Alprazolam, Flunitrazepam, Bromazepam, Clobazam, Clonazepam, Diazepam, Lorazepam, Midazolam, Nitrazepam, Oxazepam, Temazepam.

Other strong sleeping tablets

Zolpidem, Zopiclone.

Stimulants for ADHD or narcolepsy

Dexamphetamine, Lisdexamfetamine, Methylphenidate.

Other high-risk medicines

Ketamine, Quetiapine.

These medicines were determined based on a study, conducted by Austin Health, of local and international research which informed recommendations from the SafeScript Expert Advisory Group.

2019 review of medicines monitored in SafeScript

In the lead up to SafeScript becoming mandatory in April 2020, an update of the literature review was commissioned in early 2019 to determine if there was any significant new evidence of harm associated with medicines not currently monitored in SafeScript. These findings were then reviewed by the SafeScript Expert Advisory Group.

Medicines looked at in detail in the updated review included pregabalin (used for neuropathic pain), tramadol (a synthetic opioid pain reliever) and olanzapine (treatment for psychiatric conditions). The Expert Advisory Group did not recommend any new medicines be added to the list of those currently monitored.

In the case of pregabalin, the literature review found evidence of harm only when pregabalin was used in combination with opioids or benzodiazepines, not when prescribed on its own. Overall, the scale of harm for these medicines considered in the 2019 review was not at the same level compared to medicines currently monitored in SafeScript.

While no additional medicines will be included in SafeScript at this stage, the department will continue to closely observe data and review any new evidence of harm for the medicines considered in the 2019 review and indeed any medicine not currently monitored.

A framework has been developed to guide future recommendations on the inclusion of additional Schedule 4 medicines in SafeScript. This will enable a consistent, transparent and evidence-based approach to be applied when a medicine is being considered for monitoring in SafeScript.  

Copies of the initial literature review, the updated review and the criteria for inclusion of additional medicines in SafeScript are available here: 

Literature review – March 2017

Updated literature review – May 2019

Criteria for inclusion of additional medicines in SafeScript