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.

Hot topics

WHO guidelines for treatment of cancer pain published

The World Health Organisation (WHO) has published ‘Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. For more information, click here

WHO discontinues two pain management guidelines

WHO is discontinuing the following two guidelines in light of new scientific evidence that has emerged since the time of their publication and to address issues of conflicts of interest of the experts that have been raised:

  • Ensuring balance in national policies on controlled substances: Guidance for availability and accessibility of controlled medicines (2011)
  • WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses (2012).

For more information, click here.

Safer management of controlled drugs

The annual report on the safer management of controlled drugs for 2018 has been published by the Care Quality Commission. As part of the recommendations, all health professionals are reminded of their responsibility to speak up on areas of concern that might negatively affect patient safety, including prescribing, administering, dispensing, supplying and disposing of controlled drugs. For more information, click here.

Valproate further prescribing resources

The following resources are available to support the prescribing of valproate in females of child-bearing potential. For more information on the risks of valproate in pregnancy, see our previous news item in April 2018.

Pan college guidance

This has been produced by experts from 13 national healthcare bodies, including Royal Colleges and the Royal Pharmaceutical Society for use in the authorised indications of epilepsy and bipolar disorders. It advises on the more challenging issues that health professionals in primary and specialist care might encounter in daily practice, e.g. transition from paediatric to adult services, competence to consent to treatment, and confidentiality. For more information, click here.

NICE summary

NICE has produced a summary of their guidance and safety advice for valproate, including for off-label indications. For more information, click here.

Paediatric guidance

The British Paediatric Neurology Association (BPNA) and the Royal College of Paediatrics and Child Health (RCPCH) have developed joint guidance about the use of valproate in female patients <18 years. For more information, click here.

Valproate updated annual risk acknowledgement form

The Annual Risk Acknowledgement Form, used as part of the Pregnancy Prevention Programme (PPP), for prescribing valproate to females of child-bearing potential has been updated following feedback from health professionals and stakeholders. This form should be used for all future reviews of female patients on valproate. For more information, click here.

NICE lung cancer guidance updated

Updated NICE guidance, Lung cancer: diagnosis and management (NG122), has been published. It covers non-small-cell and small-cell lung cancer. The only changes to the palliative care section involve signposting to other relevant NICE guidance for bone metastases and skeletal-related events. For more information, click here.

NICE consultation for end of life care service delivery

Draft guidance, for end of life care service delivery, has been under consultation and is expected to be published in October 2019. For more information, click here.

Drug updates

Epistatus 10mg oromucosal solution SPC updated

Information has been added to the SPC regarding the risk of use of Epistatus (midazolam) 10mg oromucosal solution in hepatic impairment: Because hepatic impairment reduces the clearance of midazolam and increases the terminal half-life, the clinical effects may be stronger and prolonged. Note. Epistatus is contra-indicated in patients with severe hepatic impairment.

Warnings regarding the CNS depressant risks of the concurrent use of opioids have also been added. For more information, click here.

Latest Additions

Better treatments for breathlessness in palliative care and end of life

The recently launched, EU funded BETTER-B project are seeking the views of physicians in respiratory and palliative medicine on the management of chronic breathlessness for patients with severe chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and lung cancer. We encourage our members to complete the survey, which takes approximately 10−15minutes. The survey will close at the end of July 2019. Click here, to learn more and complete the survey.

NSAIDs – What do you use?

Results are available from our survey on the use of Non-Steroidal Anti-inflammatory drugs (NSAIDs). For more information, click here.

PCF updated monographs

The on-line PCF is being continually updated. Some of the website monographs now supersede those in the print publication of the 6th edition of the Palliative Care Formulary (PCF6). During March to June 2019 the following monographs have been updated and can be accessed on the MedicinesComplete website:

Chapter 01: Topical products for haemorrhoids

Chapter 02: Furosemide, Haemostatics, Spironolactone

Chapter 04: Gabapentin and pregabalin (minor change), Valproate (minor change)

Chapter 05: QCG: Use of transdermal fentanyl patches (minor change), QCG: Use of buprenorphine transdermal patches (minor change)

Chapter 07: Bisphosphonates (minor change), Desmopressin, Danazol, Progestogens

Chapter 08: Tamsulosin, Urinary antimuscarinics (previously oxybutynin)

Chapter 18: Hepatic impairment

Chapter 30: Transdermal patches (minor change).

A full list of all the monographs updated since the publication of PCF6 can be found on the Latest additions section of the website, along with more details of the minor updates. In addition, follow @palliativedrugs on twitter for the latest updates.


Prepared by Sarah Charlesworth and Andrew Wilcock

(Visited 354 times, 1 visits today)