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Pre-publication offer extended: PCF6 for the same price as PCF5!

5th October 2017

We are pleased to announce the forthcoming publication of the 6th edition of the Palliative Care Formulary (PCF6) book. We anticipate that it will be available late October 2017. As a special pre-publication offer, PCF6 purchased during September and early October 2017 will cost only £50 (including P+ P in the UK). The usual price of PCF6 remains to be finalised, but it will cost a minimum of £55.

As well as being extensively updated, PCF6 has been re-organised into a more user-friendly format and contains new monographs.

To pre-order your copy of PCF6 book and take advantage of this special offer, click here.

Please note if you require bulk purchases please contact hq@palliativedrugs.com to discuss your requirements.

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High-dose loperamide: reports of serious cardiovascular events

28th September 2017

The MHRA has warned that serious and fatal cardiovascular events including QT prolongation, torsades de pointes, and cardiac arrest have occurred in patients who have taken high doses of loperamide as a drug of abuse or misuse. Similar warnings have been issued by the US FDA. The daily doses reported range from 40−800mg (the recommended maximum dose is 16mg/24h). Health professionals are reminded that naloxone can be used if symptoms of overdose occur, although due to the long duration of action, repeat treatment may be required.

Editors note. Doses higher than recommended are sometimes used in palliative care, however this practice should be avoided in patients at risk of cardiac arrhythmia or in a patient taking a CYP3A4 inhibitor; rarely cardiac arrhythmias have been reported in these patients even when taking therapeutic doses (see our loperamide monograph).

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OTC miconazole oral gel contra-indicated in patients on warfarin

27th September 2017

The MHRA have stated that patients taking warfarin should not use OTC miconazole gel. This measure has been implemented following a review of reports of serious and fatal bleeding events in patients using topical miconazole when on warfarin (see our news item). If prescribers plan to use miconazole oral gel in a patient taking warfarin, patients should be closely monitored during and after the course of treatment and advised to stop the gel and seek immediate medical attention if any bleeding or unexplained bruising occurs.

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