News and updates from

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

Safety issues

Bisphosphonates and osteonecrosis of the external auditory canal

MHRA have warned that osteonecrosis of the external auditory canal has been reported very rarely (<0.01%) with bisphosphonates, mostly in association with long-term therapy of >2 years. The possibility of this condition should be considered in patients on bisphosphonates who present with ear symptoms, including chronic ear infections, or in patients with suspected cholesteatoma. Risk factors include steroid use and chemotherapy. For more information, click here.

Hot topics

Care of the dying: NICE guidelines published

NICE has published the guidelines for the care of the dying adult (NG31). This follows a consultation period earlier in the year (also see our news item 30 July 2015 and discussion on our Bulletin board). The prescribing tables, for the use of drugs by non-specialists, have been removed and are being further developed separately as an additional resource. The full guideline and the consultation responses can be downloaded from the links below.

NG31 Guidelines for the care of the dying adult

Consultation resposnses


Cochrane review: Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy

A new Cochrane review (CD009464) has been published in full on-line. The authors’ concluded that although consideration needs to be made of the undesirable effects profile of cannabinoids, they are a useful adjunctive treatment to consider for people on moderately or highly emetic chemotherapy when all other anti-emetic options have been tried.


Opioids Aware: a good practice resource to support opioid prescribing

The Faculty of Pain Medicine, in conjunction with Public Health England, has launched a good practice prescribing resource for opioids, ‘Opioids Aware’. It replaces and expands the British Pain Society guidance ‘Opioids in persistent pain’ (2010) and although mostly focusses on opioid use for long-term non-cancer pain indications, acute pain and palliative care are also mentioned.


NHS England pain management formulary for prisons

NHS England has published a pain management formulary and an implementation guide for the treatment of acute, persistent and neuropathic pain in patients in prison. It does not include the management of pain in palliative care, but the formulary may provide support and extra information on the specific challenges of prescribing analgesic drugs in prisons. For more information, click here.

Drug updates

Cyclizine injection 50mg/mL supply difficulties

There is a shortage of cyclizine 50mg/mL injection (AmdiPharm Mercury) in some areas of the UK. There is no alternative authorized cyclizine injection available in the UK. We understand that a limited delivery was sent to Alliance wholesalers last week and the injection is temporarily back in stock.


Naloxegol approved by SMC

Naloxegol (Moventig; Astra Zeneca) has been approved by the Scottish Medicines Consortium (SMC) for use in NHS Scotland for treating opioid-induced constipation in adults whose constipation has not adequately responded to laxatives. Naloxegol was recently launched in the UK (see our news item 14 October 2015). For more information, click here.


Losec injection and infusion discontinued

AstraZeneca has discontinued Losec (omeprazole) 40mg injection and 40mg powder for solution for infusion, with effect from December 2015 in the UK. A generic version of omeprazole 40mg powder for solution for infusion is available from Sandoz. For the SPC, click here.

Latest additions

Website satisfaction survey winners and results

Results from our satisfaction survey (October – December 2015).


We are delighted to announce the five winners to receive their choice of either a complimentary copy of the PCF5+ 2015 PDF or a year’s annual subscription to the on-line PCF:

Dr Madalena Feio, Instituto Português de Oncologia de Lisboa, Portugal

Dr Andrew Williams, Greenwich and Bexley Community Hospice, UK

Dr Saskie Dorman, Poole Hospital NHS Foundation Trust, UK

Natalie Fasham, Pharmacist, Cynthia Spencer Hospice, Northampton, UK

Emma Foreman, Pharmacist, Royal Sussex County Hospital, UK

Congratulations and thank you for your support. Please continue to let us know of anything you think we could improve (e-mail


Calling all members – New year Document library update!

Our Document library is now nearly 14 years old! We are very grateful to those members who have supported the concept of sharing information for the benefit of others and submitted guidelines, policies and patient information leaflets over the years.

However, in order to keep the Document library current and useful, if you have submitted documents to our Document library in the past, we would be grateful if you would review the version currently shown on-line, inform us if it is out of date and ideally send us an updated version.

In addition, we would welcome any new documents. Please send them in any format to confirming that you have the permission of the author to share the document on-line with the palliative care community.


Prepared by Sarah Charlesworth and Andrew Wilcock

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