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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, UK
  1. Correspondence to Sarah Charlesworth, Hayward House Study Centre,, Nottingham University Hospitals, City Campus, Hucknall Road, Nottingham, 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 featured in the News and Latest additions sections in recent months; for additional information, please register for free on the website.

Safety updates

Food and drug administration (FDA) restricts codeine and tramadol in children and adolescents

As part of an ongoing safety review, the FDA has further restricted the use of codeine and tramadol.

  • Codeine is contraindicated for the treatment of pain or cough in children <12 years.

  • Tramadol is contraindicated for the treatment of pain in children <12 years.

  • Codeine and tramadol are contraindicated in children <18 years to treat pain after surgery to remove the tonsils and/or adenoids.

  • It is recommended that codeine and tramadol are not used in adolescents 12−18 years who are obese or have conditions such as obstructive sleep apnoea or severe lung disease, which may increase the risk of serious breathing problems.

  • It is recommended that codeine and tramadol are not used by breastfeeding mothers.

Note: The restrictions for codeine reflect those issued in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) in April 2015 (for cough) and July …

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  • Competing interests None declared.

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