07/04/2017
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
Cochrane review: pharmacological interventions for pruritus in adult palliative care
patients
In this update to the original review in 2013, the authors concluded that there were was
low–moderate quality evidence for gabapentin, nalfurafine and cromolyn sodium for itch
associated with chronic kidney disease, and rifampicin and flumecinol for itch associated with
cholestasis. Paroxetine may be useful for palliative care patients with itch of various aetiologies,
although evidence was only available from one study. For more information, click here.
Cochrane review: paracetamol with or without codeine or dihydrocodeine for neuropathic pain in adults
The authors concluded that there was insufficient evidence to support or refute the use of
paracetamol alone or with codeine or dihydrocodeine for neuropathic pain in adults. For more
information, click here.
Cochrane review: topical capsaicin (high concentration) for chronic neuropathic pain in
adults
In this update to the original review in 2013, the authors concluded that there is moderate quality
evidence that high-concentration (8%) capsaicin patches can give moderate pain relief, or better,
to a minority of people with post-herpetic neuralgia, and very low quality evidence that it benefits
those with HIV-neuropathy and peripheral diabetic neuropathy. For more information, click here.
Scottish Medicines Consortium: Butec patches for chronic non-malignant pain
The Scottish Medicines Consortium has accepted buprenorphine transdermal patches (Butec ® )
within NHS Scotland for chronic non-malignant pain of moderate intensity when an opioid is
necessary for adequate analgesia. It is restricted to use in patients >65 years. For more
information, click here.
NICE evidence summary: oral glycopyrronium bromide for severe sialorrhoea
NICE has produced an evidence summary for the use of oral glycopyrronium bromide in children
and young people with chronic neurological disorders. For more information, click here.
Drug updates
Glycopyrronium oral solution authorized for drooling now available in UK
Glycopyrronium 320microgram/mL oral solution (Sialanar ® ; equivalent to 400microgram/mL or
2mg/5mL glycopyrronium bromide), authorized for severe drooling in children and adolescents ≥3
years with chronic neurological disease, is now available. The NHS cost for 250mL bottle is £320.
It is authorized for use via EFT and doses must be reduced in renal impairment. Due to lack of
data the product is not authorized in adults or for long-term use. For the SPC, click here.
A glycopyrronium bromide 200microgram/mL (1mg/5mL; Colonis Pharmaceuticals) oral solution,
authorized for adults for the treatment of peptic ulceration is also available (see our news item
30th September 2016).
Glycopyrronium bromide
Tablets 1mg, 2mg, 28 days@ 1mg t.d.s. = £602.
Oral solution 1mg/5mL, 2mg/5mL 28 days @ 1mg t.d.s. = £255 or £269 respectively.
Injection 200microgram/mL, 1mL or 3mL amp = £1.20.
Note: other strengths of glycopyrronium bromide oral solution and oral suspension are also
available as unauthorized products via special order 200micorgram/5mL, 500micorgram/5mL,
2.5mg/5mL, 5mg/5mL.
FDA approves 2mg naloxone nasal spray
A 2mg naloxone nasal spray (Narcan ® ; Adapt Pharma) has been approved in the USA for use in
opioid-dependent patients, expected to be at risk for severe opioid withdrawal, in situations where
there is a low risk for accidental or intentional opioid exposure by household contacts.
A 4mg naloxone nasal spray (Narcan ® ; Adapt Pharma) has been available since February 2016
(see our news item 26-11- 2016).
The US Product Information for both the 2mg and 4mg naloxone nasal spray can be downloaded
from here. For more information, click here.
Thalidomide updated SPC
The UK SPC for thalidomide Celgene 50mg hard capsules now advises extra care when removing
capsules from the blister to avoid deformation/breakage and recommends to only press one end of
the capsule to remove from the blister. In addition, it highlights capsules should not be
opened/crushed. If powder makes contact with skin/mucous membranes, it should be washed or
flushed immediately/with water. For the SPC, click here.
Latest additions
Website satisfaction survey winners and results
Results are available from our satisfaction survey (October – December 2016). Congratulations to
the 5 members randomly selected to receive a free of copy of Introducing Palliative Care 5th
edition (IPC5).
PCF updates
The on-line Palliative Care Formulary is being continually updated. For a full list of all the
monographs updated since the print publication of PCF5, see the Latest additions section of the
website or follow us on twitter @palliativedrugs for the latest updates. Over the next few months
we will be working hard in the background on the technical side of the website in preparation for
the publication of PCF6 print edition later this year. Part 2 of PCF (which contains the general
topics) is being reorganised to make it more user-friendly. The new PCF format will be launched
first on the website in April 2017 and will also contain multiple monographs that have been
updated during the interim period.
Prepared by Sarah Charlesworth and Andrew Wilcock