{"id":967,"date":"2014-08-13T11:26:16","date_gmt":"2014-08-13T11:26:16","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/spcare\/?p=967"},"modified":"2014-08-13T11:26:16","modified_gmt":"2014-08-13T11:26:16","slug":"news-and-updates-from-www-palliativedrugs-com-66","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/spcare\/2014\/08\/13\/news-and-updates-from-www-palliativedrugs-com-66\/","title":{"rendered":"News and updates from www.palliativedrugs.com"},"content":{"rendered":"<p>Selected items from the News and Latest Additions sections of <a href=\"www.palliativedrugs.com\" target=\"_blank\">www.palliativedrugs.com<\/a>, the world\u2019s leading palliative care website.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Safety updates<\/strong><\/p>\n<p><strong>Class 2 Medicines Recall: Midazolam buccal liquid 10mg\/mL (unauthorized)<br \/>\n<\/strong>The UK MHRA has issued a class 2 medicines recall (action within 48h) for specific batches of Midazolam buccal liquid 10mg\/mL, 5mL (unauthorized product manufactured under a Specials Licence by Penn Pharma, distributed in Quantum Pharmaceutical livery). The screw caps on some units have not been correctly placed during manufacture, which may result in evaporation of the aqueous component of the product and thus an increase in the concentration of midazolam. For more information, click <a href=\"http:\/\/www.mhra.gov.uk\/Publications\/Safetywarnings\/DrugAlerts\/CON435842\" target=\"_blank\">here<\/a>.<\/p>\n<p><strong>Class 2 Medicines Recall: Buccolam (midazolam) oromucosal solutions<br \/>\n<\/strong>The UK MHRA has issued a class 2 medicines recall (action within 48h) for specific batches of Buccolam (midazolam) oromucosal solution 2.5mg, 5mg, 7.5mg and 10mg (ViroPharma SPRL). This is following a routine inspection of the company\u2019s contract manufacturing site in the UK. The inspection identified the possibility for chemical contamination. No evidence of contamination has been identified within Buccolam oromucosal solution on the market. Replacement stocks of Buccolam are available. For full information, including affected batch numbers, click <a href=\"http:\/\/www.mhra.gov.uk\/Publications\/Safetywarnings\/DrugAlerts\/CON439803\" target=\"_blank\">here<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Hot topics<\/strong><\/p>\n<p><strong>New drug driving offence \u2013 Department for Transport guidance<br \/>\n<\/strong>The UK Government Department for Transport has produced guidance for health professionals on the new drug driving offence; driving in excess of specified levels of certain controlled drugs in the body. This offence, which is in addition to the existing rules on drug impaired driving and fitness to drive, is expected to come into force on 2 March 2015 (see our previous news items <a href=\"http:\/\/www.palliativedrugs.com\/news\/january\/new-drug-driving-offence-changes-to-spcs-and-product-labelling.html\" target=\"_blank\">07 January 2014<\/a> and <a href=\"http:\/\/www.palliativedrugs.com\/news\/august\/driving-under-the-influence-of-drugs-government-consultation.html\" target=\"_blank\">08 August 2013<\/a>). For more information, click <a href=\"https:\/\/www.gov.uk\/government\/publications\/drug-driving-and-medicine-advice-for-healthcare-professionals\" target=\"_blank\">here<\/a>.<\/p>\n<p><strong>Cochrane reviews<\/strong><br \/>\nThe following Cochrane reviews have been published in full on-line:<\/p>\n<ul>\n<li>low molecular weight heparin versus unfractionated heparin for perioperative thromboprophylaxis in patients with cancer (<a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/14651858.CD009447.pub2\/full\" target=\"_blank\">CD009227<\/a>)<\/li>\n<li>oxycodone for neuropathic pain and fibromyalgia in adults (<a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/14651858.CD010692.pub2\/full\" target=\"_blank\">CD010692<\/a>).<\/li>\n<\/ul>\n<p><strong>BNF changes to haloperidol maximum dose<br \/>\n<\/strong>In May 2014, the BNF changed the PO dosing schedule of haloperidol for the treatment of schizophrenia, mania and psychoses, and reduced the maximum recommended PO dose to 20mg\/day in divided doses. This was in line with changes in the Haldol SPC (Janssen) that were made in line with recent studies that used lower doses of antipyschotics due to the known risk of QT prolongation and other adverse effects. The BNF has now also reduced the maximum IM dose from 20mg\/day to 12mg\/day in divided doses, based on a PO haloperidol bio-availability of about 60%. The BNF notes that some of the generic SPCs for both the PO and IM formulations are yet to be amended and have highlighted this inconsistency to the MHRA. Thus, they have noted that BNF doses may differ from the product literature. For more information, click <a href=\"http:\/\/www.pharmpress.com\/mailouts\/bnf\/jun14\/BNF_enewsletter.html\" target=\"_blank\">here<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Drug updates<\/strong><\/p>\n<p><strong>New fentanyl sublingual tablet launched in UK<br \/>\n<\/strong>A fentanyl sublingual tablet (Recivit; Grunenthal) has been launched in the UK for the treatment of breakthrough pain in adults who are already receiving maintenance opioid therapy for chronic cancer pain. The sublingual tablets are available as 133, 267, 400 and 533 and 800microgram and are not interchangeable with other forms of transmucosal fentanyl, i.e. the dose must be individually titrated for each patient. Each sublingual tablet costs \u00a34.50. For the SPC, click <a href=\"http:\/\/www.medicines.org.uk\/emc\/medicine\/28821\" target=\"_blank\">here<\/a>.<\/p>\n<p><strong>Tapentadol oral solution launched in UK<br \/>\n<\/strong>Tapentadol oral solution 20mg\/mL (Palexia: Grunenthal) has been launched in the UK for the treatment of moderate to severe acute pain in adults which can be managed only with opioid analgesics. It is available in 100mL and 200mL packs and the cost of a 50mg (2.5mL) dose = \u00a30.45, which is equivalent to the tablet formulation. The dose can be taken undiluted or diluted in water or any non-alcoholic cold drink and is also suitable for administration via enteral feeding tubes. For the SPC, click <a href=\"http:\/\/www.medicines.org.uk\/emc\/medicine\/28765\" target=\"_blank\">here<\/a>.<\/p>\n<p><strong>New oxycodone m\/r tablet launched in UK<br \/>\n<\/strong>An oxycodone 12h m\/r tablet (Dolocodon\u00ae PR: Zentiva) has been launched in the UK for the treatment of severe pain which can be adequately managed only with opioid analgesics. The m\/r tablets are available in 5, 10, 20 and 40mg and the cost of 28 days @ 10mg, 20mg, and 40mg b.d. = \u00a325, \u00a350, and \u00a3100 respectively. For the SPC, click <a href=\"http:\/\/www.medicines.org.uk\/emc\/medicine\/28197\" target=\"_blank\">here<\/a>.<\/p>\n<p><strong>New oxycodone immediate-release generic capsule launched in UK<br \/>\n<\/strong>An oxycodone immediate-release capsule (Lynlor: Actavis) has been launched in the UK for the treatment of severe pain which can be adequately managed only with opioid analgesics. The immediate-release generic oxycodone capsules are available in 5, 10, and 20mg. For the SPC, click <a href=\"http:\/\/www.medicines.org.uk\/emc\/medicine\/28113\" target=\"_blank\">here<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Latest additions<\/strong><\/p>\n<p><strong>Switching between morphine and hydromorphone \u2013 What conversion ratio do you use?<br \/>\n<\/strong>Results from our <a href=\"http:\/\/www.palliativedrugs.com\/download\/140703_morphine_hydromorphone_v02.pdf\" target=\"_blank\">survey<\/a> (March 2014 \u2013 June 2014).<\/p>\n<p><strong>PCF updated monographs<br \/>\n<\/strong>The following monographs of the on-line <a href=\"http:\/\/www.palliativedrugs.com\/\" target=\"_blank\">Palliative Care Formulary<\/a> (PCF) have been updated during July 2014 and supersede those in the publication of the 4th edition of the Palliative Care formulary (PCF4) and PCF4+2013 epdf. They can be accessed from the formulary section of the website:<\/p>\n<p>Chapter 27: <a href=\"http:\/\/www.palliativedrugs.com\/formulary\/en\/anaphylaxis.html\" target=\"_blank\">Anaphylaxis<\/a><\/p>\n<p>For a full list of all the monographs updated since the publication of PCF4, click <a href=\"http:\/\/www.palliativedrugs.com\/download\/PCF_updated_monographs_list_1407_final_sc.pdf\" target=\"_blank\">here<\/a>. Follow us on twitter @palliativedrugs for the latest updates.<\/p>\n<p>&nbsp;<\/p>\n<p>Prepared by Sarah Charlesworth and Andrew Wilcock<\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world\u2019s leading palliative care website. &nbsp; Safety updates Class 2 Medicines Recall: Midazolam buccal liquid 10mg\/mL (unauthorized) The UK MHRA has issued a class 2 medicines recall (action within 48h) for specific batches of Midazolam buccal liquid 10mg\/mL, 5mL (unauthorized product manufactured under [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/spcare\/2014\/08\/13\/news-and-updates-from-www-palliativedrugs-com-66\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":201,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[2833],"tags":[],"class_list":["post-967","post","type-post","status-publish","format-standard","hentry","category-updates-from-www-palliativedrugs-com"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts\/967","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/users\/201"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/comments?post=967"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/posts\/967\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/media?parent=967"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/categories?post=967"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/spcare\/wp-json\/wp\/v2\/tags?post=967"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}