News and updates from www.palliativedrugs.com

Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website with over 30,000 members from 169 Countries.

Safety issues

Desmopressin patient safety alert

NHS England has issued a patient safety alert warning (NHS/PSA/W/2016/001) on the risk of severe harm or death when desmopressin is omitted or delayed in patients with diabetes insipidus. They have identified a lack of awareness of the critical nature of desmopressin when being used for the treatment of cranial diabetes, in particular for the nasal spray, amongst medical, pharmacy and nursing staff and poor availability of the medication within inpatient clinical areas. Organizations are required to act immediately to ensure all staff are aware of this warning and action plans are put in place to reduce the risk. For more information, click here.

Hyperkalaemia with spironolactone and renin-angiotensin system drugs

The latest Drug Safety Update from the UK MHRA highlights the risk of potentially fatal hyperkalaemia with the concomitant use of spironolactone and angiotensin converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB). This follows a recent increase in the number of incidents reported from using these combinations. Health professionals are reminded that concomitant use of spironolactone and ACEi or ARBs is not routinely recommended. If concomitant use is essential, the lowest effective doses should be used and regular monitoring of serum electrolytes is also essential. For more information, click here.

Hot topics

NICE guidance published

  • Motor neurone disease: assessment and management (NG42). This updated version replaces NICE guideline CG105 (July 2010)
  • Transition from children’s to adults’ services for young people using health or social care services (NG43).

USA guidelines for prescribing opioids for chronic pain

The USA Centres for Disease Control and prevention (CDC) has updated a 2014 systematic review to provide 12 recommendations for prescribing opioids, in primary care, for chronic pain outside of active cancer treatment, palliative or end of life care. For more information, click here.

Drug updates

Metoclopramide 5mg/mL injection (Maxolon) batch recall

The following batches of Maxolon 5mg/mL, 2mL ampoules (metoclopramide; AMco) have been recalled due to a printing error on the outer carton regarding IV administration.

  • batch number J001 (expiry April 2020)
  • batch number J003 (expiry October 2020).

For more information, click here.

New fentanyl transdermal patient controlled system available in UK

A new fentanyl transdermal system (IONSYS), authorized for the treatment of moderate−severe post-operative pain in adults, is now available in the UK (hospital use only). The patient controlled transdermal system has an electronic controller, a drug unit and a patient activation button. Upon pressing the activation button, 40microgram of fentanyl is delivered to the patient over a 10minute period. The unit contains 80 doses and allows a maximum of 6 doses/h (240microgram/h). It is authorized for short term use for 72h. For more information, click here.

Editor’s note: An IONSYS product has previously been available in the UK but was suspended in 2008 due to a defect in the delivery system (see our news items on 30 September and 25 November 2008).

Special order ketamine capsules available in UK

Ketamine oral capsules are now available as an unauthorized product for special order. They are available as 10mg and 40mg in a pack of 100 at a cost of £189 and £199 (+VAT) from the NHS Oxford pharmacy store (01865 455909). They have a 12month shelf life. For more information, click here.

Latest additions

Survey results

Results from our survey ‘Benzodiazepines and hypnotics – What do you use?’, (January– March 2016).

Prepared by Sarah Charlesworth and Andrew Wilcock