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

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The website 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. The UK Palliative Care Formulary 5th edition (book, PDF and online versions) and Introducing Palliative Care 5th edition can also be purchased via the website. This feature provides a selection of items that have been featured in the News and Latest additions sections in recent months; for additional information, please register for free on the website.

Safety updates

MHRA warning regarding hyoscine butylbromide

The Medicines and Healthcare products Regulatory Agency (MHRA) published a warning in February 2017 reminding health professionals about the risk of serious adverse effects with hyoscine butylbromide injection intravenously/intramuscularly in patients with underlying cardiac disease. This followed a recent fatality (cardiac arrest) and a subsequent recommendation from the coroner to clarify the cautions section in Summary of Product Characteristics (SPC). The MHRA stated that they had received nine reports of patients who had died following receiving hyoscine butylbromide injection and published the following advice:

  • Hyoscine butylbromide injection can cause serious adverse effects, including tachycardia, hypotension and anaphylaxis.

  • These adverse effects can result in a fatal outcome in patients with underlying cardiac disease, such as those with heart failure, coronary heart disease, cardiac arrhythmia or hypertension.

  • Hyoscine butylbromide injection should be used with caution in patients with cardiac …

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  • Competing interests None declared.

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