Syringe Driver Survey Database migration to MedicinesComplete - January 2023

Syringe Driver Survey Database has moved to MedicinesComplete and is no longer available on palliativedrugs.com.

It has been renamed to PCF’s Syringe Driver Database and is now accessed through Drug Compatibility Checker.

Drug Compatibility Checker, through MedicinesComplete is a new tool providing essential compatibility knowledge to support the administration of injectable drugs combining published data and clinical practice reports.

Find out more about Drug Compatibility Checker:https://about.medicinescomplete.com/publication/drug-compatibility-checker/

If you have a subscription to Palliative Care Formulary through MedicinesComplete, you will have access to PCF’s Syringe Driver Database through Drug Compatibility Checker, at no charge through 2023. 

To contribute to PCF’s Syringe Driver Database please continue to submit a clinical practice report using palliativedrugs.com here: https://www.palliativedrugs.com/syringe-driver-database.html

To learn more about a subscription to the Palliative Care Formulary through MedicinesComplete, please contact us here: https://info.medicinescomplete.com/sales

If you have any questions regarding access to PCF’s Syringe Driver Database or would like to renew your subscription to Palliative Care Formulary, please contact pharmpress-support@rpharms.com.

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Citalopram and escitalopram maximum daily doses restricted

15th December 2011

Restrictions on the maximum daily doses of citalopram and escitalopram have been made following the evaluation of a QT study by the UK Medicines and Healthcare products Regulatory Agency (MHRA). The study showed dose-dependent QT interval prolongation with citalopram and escitalopram, and post-marketing reports of prolonged QT interval have also been received. A similar decision was taken by the US Food and Drug Administration last year (see our news item 25-08-11).

Citalopram

The maximum daily dose of citalopram should be restricted to 40mg (20mg in the elderly or those with hepatic impairment).

Escitalopram

The maximum daily dose of escitalopram for adults <65 years remains 20mg daily, however in adults >65 years, the dose has been reduced to 10mg daily.

Citalopram and escitalopram are contra-indicated in patients with known QT interval prolongation or congenital long QT syndrome and in conjunction with other products known to prolong the QT interval. These include;

• class IA and III antiarrhythmics (eg, amiodarone, dronedarone, quinidine)
• antipsychotics (eg, fentiazine derviatives, pimozide, haloperidol)
• tricyclic antidepressants
• some antimicrobial agents (eg, sparfloxacin, moxifloxacin, erythromycin IV, pentamidine, antimalaria treatment - particularly halofantrine)
• some antihistamines (astemizole, mizolastine)
• some antiretrovirals (eg, ritonavir, saquinavir, lopinavir).

Caution is advised in patients with underlying heart conditions and those who are predisposed to low serum levels of potassium and magnesium.

Doses of citalopram and escitalopram may also need to be reduced if used in conjunction with drugs that increase their plasma levels e.g. some antiretrovirals, omeprazole and cimetidine.

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