Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website with over 30,000 members from 169 Countries.
Hot topics
Motor Neurone Disease: NICE guideline consultation
NICE have published a draft guideline for consultation for motor neurone disease (closing 13 October 2015), The guideline covers the assessment and management of motor neurone disease, including managing symptoms of coughing, breathlessness, the use of drugs to treat muscle cramps and stiffness. For more information, click here.
Cochrane review: venlafaxine for neuropathic pain in adults
This new review has been published in full on-line (CD011091). The authors concluded that while there is some evidence that venlafaxine may be of benefit in treating neuropathic pain, it is not sufficiently robust to promote a change in prescribing practice. Venlafaxine should probably only be considered for use in people who have not responded to tricyclic antidepressants and anticonvulsants, or if there are contra-indications to these.
Update on the prescribing and dispensing of pregabalin for neuropathic pain
A High Court judgement on 10 September 2015 ruled against Pfizer in its patent infringement case for Lyrica (see our news item 10 March 2015). However, the judgement is subject to appeal and thus the Pharmaceutical Services Negotiating Committee has stated that the prescribing and dispensing guidance for pregabalin in neuropathic pain issued by NHS England, in response to a court ruling, is still to be followed until definitive unequivocal guidance is provided by another court ruling. (NHS England prescribing guidance).
Note: as previously stated, gabapentin is an alternative first-line option for neuropathic pain (see our Gabapentin and pregabalin monograph). Generic gabapentin capsules, authorized for peripheral neuropathic pain, are as effective as, and significantly cheaper than, the Lyrica brand of pregabalin. For more information, click here.
Drug updates
Magnesium aspartate dihydrate approved by NHS Wales for hypomagnesaemia
The new magnesium powder sachet for oral solution (Magnaspartate sachets; Kora Healthcare, Ireland, see our news item 15 April 2015) has been approved by NHS Wales as an option for the prevention and treatment of magnesium deficiency in children from two years, adolescents and adults. For more information, click here.
Capsaicin patch indications updated
In addition to non-diabetic peripheral neuropathy, capsaicin 179mg cutaneous patches (Qutenza; Astellas) are now authorized in the UK for the treatment of diabetic peripheral neuropathy. For more information, click here.
Lacri-Lube eye ointment recalled
UK MHRA has recalled specific batches of Lacri-Lube eye ointment 3.5g and 5g (Allergen Ltd), following a small number of reports of black particles found in some of the tube nozzles. Due to the large number of batches recalled, it is anticipated that there will be a shortage of this product, with supply unlikely to return to normal until early 2016. For further information and full details of the batches affected see below. For more information, click here.
Disipal brand of orphenadrine tablets discontinued
Astellas is discontinuing orphenadrine hydrochloride (Disipal) tablets 50mg from 1 December 2015 because of manufacturing issues. Stock can be ordered until 30 November 2015. Generic orphenadrine 50mg tablets are available, however they are currently significantly more expensive,
i.e.:
Orphenadrine (generic)
Tablets 50mg, 28 days @ 50mg t.d.s. = £67.
Oral solution 50mg/5mL, 28 days @ 50mg t.d.s. = £20.
Biorphen® (Alliance)
Oral solution (sugar-free) 25mg/5mL, 28 days @ 50mg t.d.s. = £36.
Disipal® (Astellas)
Tablets 50mg, 28 days @ 50mg t.d.s. = £3.
Latest additions
PCF updated monographs summary (September 2015)
Due to the imminent publication of PCF5+ 2015 pdf, there have been no updates to the on-line PCF this month. For a full list of all the monographs updated since the publication of PCF5, click here. Follow us on twitter @palliativedrugs for the latest updates.
Phenobarbital CSCI – How do you dilute it?
For results from our UK survey (August – September 2015), click here.
Prepared by Sarah Charlesworth and Andrew Wilcock