| Formulary Chapter 21: Palliative Care Formulary - Full Chapter
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| 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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| Chapter Links... |
 BSOL CCG - End Of Life Care Drug guidance for use in the COVID crisis – March 2020 |
| NICE 163: COVID-19 rapid guideline: managing symptoms (including at the end of life) in the communit |
| Details... |
| 21 |
Palliative Care Formulary Drugs |
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Alfentanil
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Formulary
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Injection
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 WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Atropine 1%
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Formulary
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Eye drops
Oral use for drooling/secretions in neurological disease
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Baclofen
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Formulary
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Tablets, oral liquid
For hiccup
Off label use according to WM Cares guideline
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Buprenorphine
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Formulary
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Patches
Recommend 7-day patch
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Clonazepam
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Formulary
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Tablets
Pain - off label use according to WM Cares guideline
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Co-danthramer
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Formulary
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Strong suspension
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Co-danthrusate
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Formulary
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Capsules
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Dantron
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Formulary
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Disodium pamidronate
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Formulary
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All forms
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Epinephrine/ adrenaline
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Formulary
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Injection
Topical use for fungating wounds where bleeding is present
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Fentanyl
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Furosemide
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Glucose 4% and sodium chloride 0.18%
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Formulary
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IV infusion
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Glycopyrronium
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Hyoscine hydrobromide
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Formulary
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Patches
Drooling in chronic neurological disease
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Ketorolac
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Lorazepam
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Formulary
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Tablets
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Methadone
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Formulary
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All forms
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Mirtazapine
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Formulary
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Tablets, oral solution
For pain
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Morphine
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Formulary
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Injection
Topical use for painful wounds where systemic opioids are effective but dose limited due to side-effects
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Nifedipine
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Formulary
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m/r tablets and capsules
Hiccup, tenesmus - off label use according to WM Cares guideline
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Octreotide
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Oxycodone
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Formulary
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Injection
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Pilocarpine
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Formulary
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Eye drops all strengths
Oral use - for dry mouth where routine oral mouth care and saliva substitutes have failed
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Pregabalin
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Formulary
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Capsules, oral solution
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Ranitidine
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Formulary
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Injection
Bowel obstruction
Off label use according to wmcare guideline’
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Sodium chloride 0.9%
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Formulary
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IV infusion
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Sodium picosulfate
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Formulary
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Liquid
Palliative care use only
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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Tranexamic acid
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Formulary
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Injection
Topical use for fungating wounds where bleeding is present.
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WM Cares, West Midlands Palliative Care Physicians Guidelines for the use of drugs in symptom control
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| .... |
| Non Formulary Items |
Hyoscine hydrobromide
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Non Formulary
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Injection |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
| Status |
Description |
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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.
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Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians. |
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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. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist. |
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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. |
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Medicines for initiation and maintenance prescribing by Specialists only. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest. |
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