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 updates
Denosumab: reports of osteonecrosis of the external auditory canal
UK MHRA have highlighted that there have been reports of osteonecrosis of the external auditory canal with the use of denosumab (Prolia®, Xgeva®). In December 2015, there were similar reports with the use of bisphosphonates. Both denosumab and bisphosphonates are also known to be associated with osteonecrosis of the jaw. For more information, click here.
Hot topics
BTS guideline for oxygen use 2017
The British Thoracic Society (BTS) guideline for the use of oxygen in healthcare and emergency settings has been updated and published. For more information, click here.
Cochrane review: topical analgesics for acute and chronic pain in adults
This overview of Cochrane reviews has been published in full on-line.The authors conclude that there is reliable evidence that topical diclofenac and ketoprofen gel may be useful for strains and sprains, and to a lesser extent knee and hand osteoarthritis. Topical capsaicin (high-concentration) may be of limited use in some people with postherpetic neuralgia. Topical salicylate, capsaicin (low-concentration), clonidine, and lidocaine are not well supported by evidence, or much evidence of effect. However, there may be beneficial effects in a small number of people. For more information, click here.
Cochrane review: tramadol with or without paracetamol for cancer pain
This review has been published in full on-line. The authors conclude that there is no clear evidence to support the use of tramadol in mild−moderate, or severe cancer pain in adults. Tramadol may have a role if other opioids are not tolerated, providing the issues of dose titration and possible severe undesirable effects are considered. For more information, click here.
Cochrane review: morphine for chronic neuropathic pain in adults
This review has been published in full on-line. The authors conclude that there is no convincing evidence that oral morphine ≤180mg/24h is effective in relieving neuropathic pain (e.g. ≤50% pain reduction ≤12 weeks), but note the possibility that subgroups of people may get a good response. For more information, click here.
Cochrane review: methadone for neuropathic pain
This review has been published in full on-line. The authors conclude that methadone should not be considered a first-line opioid in the treatment of neuropathic pain mostly due to the possibility of increased risk of undesirable effects compared to other opioids. For more information, click here.
Drug updates
Pregabalin prescribing restrictions to be lifted
The patent for the use of pregabalin for neuropathic pain, held by Pfizer for its oral product Lyrica®, expires on 16 July 2017 in the UK. Thus, as of 17 July 2017, the prescribing restrictions imposed by NHS England in March 2015 on the use of generic pregabalin for neuropathic pain will no longer apply. New guidance from NHS England states that after this date, ‘when prescribing/dispensing pregabalin for the treatment of any condition, you should prescribe/dispense in accordance with your normal practice’. For more information, click here.
Magnesium glycerophosphate oral tablet authorized
An authorized, chewable, magnesium glycerophosphate tablet (magnesium 4mmol/tablet) is now available for the treatment of chronic hypomagnesaemia (Neomag; Neoceuticals). The cost of 28 days @ two tablets t.d.s. (24mmol/24h) = £77. For the SPC, click here.
Epistatus 10mg oromucosal solution now authorized
The Epistatus® brand of midazolam 10mg oromucosal solution for buccal administration has been authorized in the UK for the treatment of prolonged, acute seizures in children and adolescents <18 years. The NHS list price of one prefilled syringe is £60. This product was previously unauthorized but available as a special order product. The other strengths of Epistatus® oromucosal solutions remain unauthorized. For the SPC, click here.
Note. The Epistatus® oromucosal solution is 10mg/mL; this is double the concentration of the other authorized formulation of midazolam oromucosal solution (Buccolam®) in the UK which is 5mg/mL and available as 2.5mg, 5mg, 7.5mg and 10mg prefilled oral syringes.
Capsaicin patch risk minimization guide
Risk minimization material concerning the administration of capsaicin 8% patch (Qutenza®) has been produced by Grunenthal, for use by health professionals. For more information, click here.
Magnesium glycerophosphate oral tablet authorized
An authorized, chewable, magnesium glycerophosphate tablet (magnesium 4mmol/tablet) is now available for the treatment of chronic hypomagnesaemia in the UK (Neomag®; Neoceuticals). The approximate cost of 28 days @ two tablets t.d.s. (24mmol/24h) = £77. For the SPC, click here.
Latest additions
PCF updated monographs summary
The on-line Palliative Care Formulary is being continually updated. The following monographs have been updated during June 2017 and supersede those in the print publication of the 5th edition of the Palliative Care Formulary (PCF5) and PCF5+ 2016 PDF. They can be accessed from the formulary section of the website.
Chapter 01: Simeticone (minor change), QCG: Death rattle (noisy rattling breathing)
Chapter 10: Dantrolene, Tizanidine
Chapter 11; Pilocarpine
For a full list of all the monographs updated since the print publication of PCF5, click here. Follow us on twitter @palliativedrugs for the latest updates.
Website privacy policy updated
In order to comply with the requirements for our Health on the Net code standard for trustworthy health information annual accreditation, we are required to inform our website users of changes to our privacy policy. We have recently updated this to provide information on our use of google analytics. The updated privacy policy can be found via the link at the bottom of every page or click here.
Prepared by Sarah Charlesworth and Andrew Wilcock