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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 Dr Andrew Wilcock, Department of Palliative Medicine, University of Nottingham, Hayward House Study Centre, Nottingham University Hospitals NHS Trust, NG5 1PB, UK; andrew.wilcock{at}

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The website has provided essential independent information about drugs used in palliative and hospice care for over a decade. 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 4th edition, Hospice and Palliative Care Formulary USA 2nd edition and Palliative Care Formulary Canadian edition) and an e-book pdf version of the 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

MHRA strengthened recommendations for intravenous iron

The UK Medicines and Healthcare products Regulatory Agency (MHRA) has strengthened recommendations for the administration of intravenous iron in relation to serious hypersensitivity reactions. An Europe-wide review has shown that these can occur irrespective of whether a patient has received a test dose or previous treatment with the product. Thus, because of the false reassurance they can confer, a test dose is no longer recommended. Intravenous iron should be administered strictly as per the specific Summary of Product Characteristics (SPC) (advice varies between products). With every dose of intravenous iron, resuscitation facilities must be available and patients monitored for signs of hypersensitivity during the infusion and for 30 min afterwards.

MHRA strengthened contraindications for apixaban and rivaroxaban

The UK MHRA has strengthened contraindications for the new oral anticoagulants apixaban (Eliquis) and rivaroxaban (Xarelto) in line with those for dabigatran (Pradaxa) that were introduced in July 2012. All three new oral anticoagulants are now contraindicated in patients with a lesion or condition that is considered a significant risk factor for major bleeding. Examples include; current …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.