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News and updates from palliativedrugs.com
  1. Andrew Wilcock1 and
  2. Sarah Charlesworth2
  1. 1Palliative Medicine, University of Nottingham, Nottingham, UK
  2. 2Hayward House Study Centre, Nottingham University Hospitals, palliativedrugs.com, Nottingham, UK
  1. Correspondence to Sarah Charlesworth, Hayward House Study Centre, Nottingham University Hospitals, palliativedrugs.com, City Campus, Hucknall Road, Nottingham NG5 1PB, UK; s.charlesworth{at}nhs.net

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The website http:\\www.palliativedrugs.com has provided essential independent information about drugs used in palliative and hospice care for over a decade, and has over 30 000 members from 169 countries. It contains the online Palliative Care Formulary (PCF) and provides free access to a Bulletin board to stimulate questions and share experiences, a Document library containing 475 items of useful information and a Syringe Driver Survey Database containing details of over 2350 different drug combinations. Territory-specific book versions (the UK Palliative Care Formulary 5th edition, Hospice and Palliative Care Formulary USA 2nd edition and Palliative Care Formulary Canadian edition), a PDF version of the PCF and subscription to the continually updated online PCF can also be purchased via the website. This feature provides a selection of items that have featured in the News and Latest additions sections in recent months; for additional information, please register for free on the website.

Safety updates

Enhanced warnings for opioids

US Food and Drug Administration (FDA) has announced class-wide enhanced labelling warnings for:

  • immediate-release opioid pain medications, in relation to risks of misuse, abuse, addiction, overdose and death similar to those added to modified-release formulations in 2013;

  • immediate-release and modified-release formulations, in relation to the undesirable effects on the endocrine system, and also the potential for interaction with other medicines resulting in serotonin toxicity.

The updated indication for immediate-release opioids states that they should be reserved for pain severe enough to require opioid treatment and for which alternative treatment options (eg, non-opioid analgesics or opioid combination products) are inadequate or not tolerated. The dosing information also provides clearer instructions regarding patient monitoring and drug administration, including initial dosage, dosage changes during therapy and a warning not to abruptly stop treatment in a physically dependent patient. In addition, a precaution that chronic maternal use of opioids during pregnancy can result in neonatal …

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