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News and updates from
  1. Andrew Wilcock1 and
  2. Sarah Charlesworth2
  1. 1Palliative Medicine, University of Nottingham, Nottingham, UK
  2. 2Hayward House Study Centre,, Nottingham, UK
  1. Correspondence to Andrew Wilcock, Palliative Medicine, University of Nottingham, Hayward House, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK; andrew.wilcock{at}

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Safety updates

Positive benefit–risk balance of pholcodeine-containing cough medicines

The European Medicines Agency has confirmed that the benefits of pholcodine-containing cough medicines outweigh their risks and that these medicines should remain available for the treatment of non-productive (dry) cough in children and adults. A review was initiated because of concerns that there could be cross-sensitisation between pholcodine and neuromuscular blocking agents (NMBAs), which in turn could lead to anaphylactic reactions in some patients receiving NMBAs during emergency surgery who had previously taken pholcodine. However, no firm evidence was found to substantiate these concerns.

Citalopram and escitalopram maximum daily doses restricted

Restrictions on the maximum daily doses of citalopram and escitalopram have been made following the evaluation of a QT study by the UK Medicines and Healthcare products Regulatory Agency (MHRA). The study showed dose-dependent QT interval prolongation with citalopram and escitalopram, and postmarketing reports of prolonged QT interval have also been received. A similar decision was taken by the US Food and Drug Administration (FDA) last year.

Citalopram: the maximum daily dose of citalopram is restricted to 40 mg and to 20 mg in the elderly or those with hepatic …

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  • Provenance and peer review Commissioned; internally peer reviewed.

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