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SIGN guidelines on the management of diabetes

29th November 2017

SIGN 116 guideline: management of diabetes has been updated. In addition, a new guideline, SIGN 154: pharmacological management of glycaemic control in people with type 2 diabetes, has been published. 

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Cochrane review: ketamine as an adjuvant to opioids for cancer pain

29th November 2017

This update (last updated in 2012) has been published in full on-line. The authors conclude that there is still insufficient evidence to assess the benefits and harms of ketamine as an adjuvant to opioids for the relief of refractory cancer pain. The evidence is very low quality. Rapid dose escalation of ketamine to high-dose (500mg) does not appear to have clinical benefit and may be associated with serious undesirable effects. More randomised controlled trials regarding specific low-dose ketamine clinical regimens in current use are needed.

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Calcichew-D3 500mg/400 IU caplets (Takeda) batch recall

28th November 2017

Takeda UK are recalling a specific batch of calcichew-D3 500mg/400 IU caplets due to traces of a non-approved excipient (not thought to pose a significant risk to health). The details are as follows:

Batch number: 11372123

Expiry date: May 2019

Distribution since: 15 November 2017.

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Submit your levetiracetam combinations to the SDSD

23rd November 2017

We have added levetiracetam to the drug selection list on our syringe driver survey database (SDSD). We are now able to accept and display anecdotal compatibility information on the combination of levetiracetam with other drugs. For more information on the use of levetiracetam via CSCI, see the PCF6 levetiracetam monograph.

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PCF6 book now available

21st November 2017

We are delighted to announce that the Palliative Care Formulary 6th edition, PCF6, is now available in print to purchase from our website store for £55 (including p&p in the UK). It contains the latest content of the on-line Palliative Care Formulary as of September 2017. Over these next two weeks, we will be giving priority to processing and dispatching copies to those members who pre-ordered PCF6 during September and October.

Since the publication of PCF5 in 2014, the content has been reviewed and extensively updated. PCF6 has 35 chapters and appendices, an increase of three from PCF5. In Part 1, some drug monographs have been merged and new ones added. Part 2 has been divided into Parts 2 and 3. The new chapters are all in Part 2: Prescribing in children, Renal impairment and Hepatic impairment. Part 3 covers Routes of Administration.

Although written primarily with cancer patients in mind, PCF6 contains specific material relating to several other life-limiting diseases e.g. COPD, congestive heart failure, renal failure, and Parkinson's disease. PCF also includes a number of Quick Clinical Guides

The on-line version of the Palliative Care Formulary is updated continuously and will thus provide access to the most up to date content. Details of on-line subscription including combination packages for purchasing with the print version are available from our store. Further details on bulk purchasing of any format can be obtained by contacting

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SMC accepts Epistatus 10mg oromucosal solution

17th November 2017

The Scottish Medicines Consortium (SMC) has accepted the Epistatus® brand of midazolam 10mg oromucosal solution for buccal administration for the treatment of prolonged, acute seizures in children and adolescents aged 10 to <18 years.

Note. This product was authorized earlier in 2017 (see our news item) Epistatus® oromucosal solution is 10mg/mL; this is double the concentration of the other authorized formulation of midazolam oromucosal solution (Buccolam®) in the UK, which is 5mg/mL and available as 2.5mg, 5mg, 7.5mg and 10mg prefilled oral syringes.

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Tranexamic acid 500mg tablet shortage

17th November 2017

We understand that there are currently limited supplies of generic tranexamic acid 500mg tablets due to a difficulty in manufacturers obtaining raw materials. Some supplies of branded tranexamic acid 500mg tablets (Cyklokapron), over the counter product (Cyklo-f) and some generic tranexamic acid 500mg tablets may still be available, however intermittent supply issues are expected until at least 2018.

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Gabapentin and pregabalin consultation on proposals to schedule under Misuse of Drugs Regulations

14th November 2017

The government have opened a consultation on proposals to schedule gabapentin and pregabalin under the Misuse of Drugs Regulations 2001. The preferred option, as recommended by the Advisory Council on the Misuse of Drugs (ACMD) is that these drugs should be controlled as Class C drugs (under the Misuse of drugs Act 1971) and placed in Schedule 3 (to the Misuse of Drugs Regulations 2001). Comments are welcome from all interested parties by 22 January 2018. 

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