{"id":1144,"date":"2016-07-05T08:44:01","date_gmt":"2016-07-05T08:44:01","guid":{"rendered":"https:\/\/blogs.bmj.com\/spcare\/?p=1144"},"modified":"2016-07-05T08:44:01","modified_gmt":"2016-07-05T08:44:01","slug":"news-and-updates-from-www-palliativedrugs-com-88","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/spcare\/2016\/07\/05\/news-and-updates-from-www-palliativedrugs-com-88\/","title":{"rendered":"News and updates from www.palliativedrugs.com"},"content":{"rendered":"

Selected items from the News and Latest Additions sections of www.palliativedrugs.com<\/a>, the world\u2019s leading palliative care website with over 30,000 members from 169 Countries.<\/em><\/strong><\/p>\n

Safety issues<\/h3>\n

Topical miconazole interaction with warfarin<\/strong><\/p>\n

MHRA has highlighted the risk of serious bleeding events in patients taking warfarin and using cream, ointment, powder or oral gel formulations of miconazole. The potential for a drug interaction between oral miconazole and warfarin is well documented due to miconazole inhibiting the CYP2C9 enzyme involved in the metabolism of warfarin. The MHRA are now receiving a large number of reports of potential drug interactions involving topical miconazole (particularly the oral gel formulation) and warfarin, and are now reviewing whether further measures are needed to minimise the risks to patients. In the meantime, their advice is to carefully monitor the anticoagulant effect and reduce the dose of warfarin if necessary. As some topical formulations of miconazole are available without prescription, patients taking warfarin should be warned not to use topical miconazole without consulting their doctor. For more information, click here<\/a>.<\/p>\n

Hot topics<\/h3>\n

RPS guidance for the prescribers of Specials<\/strong><\/p>\n

The Royal Pharmaceutical Society (RPS), has published guidance for the prescribers of specials. The document can be downloaded from the RPS<\/a> website, or from here<\/a>. This document was produced at the request of NICE and following consultation in 2015 (see our news item<\/a> 10 November 2015). It complements the RPS professional guidance for the procurement and supply of specials which was published in December 2015.<\/p>\n

Neuropathic pain: pregabalin and gabapentin prescribing<\/strong><\/p>\n

The latest PrescQIPP bulletin discusses dose optimisation of pregabalin and cost effectiveness in line with authorized indications and guidance from NHS England and NICE. For more information, click here<\/a>.<\/p>\n

\u00a0<\/strong>e-learning Indian palliative care course<\/strong><\/p>\n

eCancer has launched a text only version of the palliative care e-learning course for health professionals in India. For more information, click here<\/a>.<\/p>\n

Drug updates<\/h3>\n

Epistatus 10mg\/mL oromucosal solution batch recall<\/strong><\/p>\n

MHRA has issued a class 2 medicines recall for a specified batch of Epistatus (midazolam) 10mg\/mL oromucosal solution (unauthorized buccal liquid; Special products). The incorrect size of neck adaptor has been fitted and they are not compatible with oral syringes (Batch: 73234 Expiry: Oct 2017 Size: 1 x 5ml First issued: 24 Feb 2016). For more information, click here<\/a>.<\/p>\n

NICE evidence summary for fentanyl transdermal patient controlled system <\/strong><\/p>\n

NICE has published an evidence summary for the new fentanyl transdermal system (IONSYS) that was launched earlier this year in the UK (see our news item<\/a> 28 March 2016). It is authorized for the treatment of moderate\u2212severe post-operative pain in adults (hospital use only).<\/p>\n

NICE conclude that the fentanyl transdermal system has comparable efficacy to IV morphine patient-controlled analgesia (PCA). Its undesirable effect profile is as expected for an opioid used in post\u2011operative pain, and is similar to that of IV morphine PCA. They report a better patient satisfaction than IV morphine PCA but a higher drug cost. For more information, click here<\/a>.<\/p>\n

New naproxen suspension available in UK<\/strong><\/p>\n

A new authorized naproxen oral suspension 125mg\/5mL (Orion Pharma) is now available. The NHS indicative cost is \u00a3110 for 100mL. This is significantly more expensive than the tablets or the effervescent tablets and the previously unauthorized special order product. The effervescent tablets are now accepted by the Scottish Medicines Consortium (SMC) for use in NHS Scotland for patients with swallowing difficulties. For more information, click here<\/a>.<\/p>\n

Naproxen (generic)<\/p>\n

Tablets<\/em><\/strong> 250mg, 500mg, 28 days @ 500mg b.d. = \u00a32.75.<\/p>\n

Tablets e\/c<\/em><\/strong> 250mg, 375mg, 500mg, 28 days @ 500mg b.d. = \u00a39.<\/p>\n

Oral solution <\/em><\/strong>125mg\/5mL, 28 days @ 500mg b.d. = \u00a31,232.<\/p>\n

Stirlescent\u00ae<\/sup> (Stirling)<\/p>\n

Tablets effervescent <\/em><\/strong>250mg, 28 days @ 500mg b.d. = \u00a344.<\/p>\n

With esomeprazole<\/strong><\/p>\n

Tablets m\/r<\/em><\/strong> naproxen 500mg e\/c + esomeprazole<\/strong> 20mg, 28 days @ 1 tablet b.d. = \u00a315. Note this product is cheaper than prescribing both drugs separately<\/em>.<\/p>\n

Latest additions<\/h3>\n

Levomepromazine for anti-emesis \u2013 How do you use it?<\/strong><\/p>\n

Results<\/a> from our survey (April\u2013 May 2016).<\/p>\n

\u00a0<\/strong>Introducing Palliative Care 5th edition (IPC5) now available.<\/strong><\/p>\n

We are pleased to announce that IPC5 is now available to purchase from our store<\/a> for \u00a325 (including p&p in the UK).<\/p>\n

IPC5 has moved from a single authorship to a collaborative project between palliativedrugs.com editorial team and eight new contributors. Updates include:<\/p>\n