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 Formulary Chapter 21: Palliative Care Formulary - Full Chapter
Notes:

This chapter has not been reviewed by BSSE APC.

Please refer to the Pan Birmingham Care Network Guideline for the use of drugs in symptom control (West Midlands palliative care physicians) your appropriate Trust Formulary. 

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21  Palliative Care Formulary Drugs
Controlled Drug Alfentanil
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Atropine 1%
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Eye drops

Oral use for drooling/secretions in neurological disease

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Baclofen
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Formulary
Amber Recommended

Tablets, oral liquid

For hiccup

Off label use according to WM Cares guideline

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Controlled Drug Buprenorphine
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Formulary
Amber Recommended

Patches

Recommend 7-day patch

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Clonazepam
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Formulary
Amber Recommended

Tablets

Pain - off label use according to WM Cares guideline

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Co-danthramer
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Formulary
Amber Recommended

Strong suspension

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Co-danthrusate
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Formulary
Amber Recommended

Capsules

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Dantron
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Formulary
Amber Recommended
 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Disodium pamidronate
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Formulary
Red

All forms

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Epinephrine/ adrenaline
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Formulary
Amber Recommended

Injection

Topical use for fungating wounds where bleeding is present

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Fentanyl
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Furosemide
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Glucose 4% and sodium chloride 0.18%
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Formulary
Amber Recommended

IV infusion

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Glycopyrronium
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Hyoscine hydrobromide
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Formulary
Green

Patches

Drooling in chronic neurological disease

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Ketorolac
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Formulary
Red

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Lorazepam
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Formulary
Amber Recommended

Tablets

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Controlled Drug Methadone
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Formulary
Red

All forms

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Mirtazapine
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Formulary
Amber Recommended

Tablets, oral solution

For pain

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Controlled Drug Morphine
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Formulary
Amber Recommended

Injection

Topical use for painful wounds where systemic opioids are effective but dose limited due to side-effects

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Nifedipine
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Formulary
Amber Recommended

m/r tablets and capsules

Hiccup, tenesmus - off label use according to WM Cares guideline

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Octreotide
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Controlled Drug Oxycodone
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Formulary
Amber Recommended

Injection

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Pilocarpine
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Formulary
Amber Recommended

Eye drops all strengths

Oral use - for dry mouth where routine oral mouth care and saliva substitutes have failed

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Controlled Drug Pregabalin
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Formulary
Amber Recommended

Capsules, oral solution

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Ranitidine
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Formulary
Amber Recommended

Injection

Bowel obstruction

Off label use according to wmcare guideline’

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Sodium chloride 0.9%
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

IV infusion

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Sodium picosulfate
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Formulary
Amber Recommended

Liquid

Palliative care use only

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
Tranexamic acid
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Injection

Topical use for fungating wounds where bleeding is present.

 
Link  WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
   
 ....
 Non Formulary Items
Hyoscine hydrobromide

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Non Formulary
Black

Injection

 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Prescribing in children

The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
  

Green

Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

Amber Initiation

Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

Amber Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

Amber SC

Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

Red

Medicines for initiation and maintenance prescribing by Specialists only.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

Grey

Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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