Cochrane review: topical capsaicin (high concentration) for chronic neuropathic pain in adults

20th February 2017

In this update to the original review in 2013, the authors concluded that there is moderate quality evidence that high-concentration (8%) capsaicin patches can give moderate pain relief, or better, to a minority of people with postherpetic neuralgia, and very low quality evidence that it benefits those with HIV-neuropathy and peripheral diabetic neuropathy.

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Thalidomide updated SPC

17th February 2017

The UK SPC for thalidomide Celgene 50mg hard capsules now advises extra care when removing capsules from the blister to avoid deformation/breakage and recommends to only press one end of the capsule to remove from the blister. In addition, it highlights capsules should not be opened/crushed. If powder makes contact with skin/mucous membranes, it should be washed or flushed immediately/with water.

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Scottish Medicines Consortium: Noqdirna

14th February 2017

The Scottish Medicines Consortium (SMC) does not recommend desmopressin SL tablets (Noqdirna), for use within NHS Scotland, for symptomatic nocturia due to idiopathic nocturnal polyuria in adults. The SMC states that the submitting company did not present a sufficiently robust economic analysis to gain acceptance.

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NICE evidence summary: oral glycopyrronium bromide for severe sialorrhoea

14th February 2017

NICE has produced an evidence summary for the use of oral glycopyrronium bromide in children and young people with chronic neurological disorders.

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Cochrane review: pharmacological interventions for pruritus in adult palliative care patients

8th February 2017

In this update to the original review in 2013, the authors concluded that different interventions tend to be effective for cholestatic and uraemic pruritus, however treatments for patients with cancer are still lacking.

Low to moderate quality evidence indicated some possibly useful treatments.These included gabapentin, nalfurafine and cromolyn sodium for itch associated with chronic kidney disease, and rifampicin and flumecinol for itch associated with liver problems. Paroxetine may be useful for palliative care patients whatever the cause of the itching, although evidence was only available from one study.

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Cochrane review: paracetamol with or without codeine or dihydrocodeine for neuropathic pain in adults

8th February 2017

The authors concluded that there was insufficient evidence to support or refute the use of paracetamol alone or with codeine or dihydrocodeine for neuropathic pain in adults.

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Scottish Medicines Consortium: Butec patches for chronic non-malignant pain

8th February 2017

The Scottish Medicines Consortium has accepted buprenorphine transdermal patches (Butec^®) within NHS Scotland for chronic non-malignant pain of moderate intensity when an opioid is necessary for adequate analgesia. It is restricted to use in patients >65 years.

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Glycopyrronium oral solution authorized for drooling now available in UK

7th February 2017

Glycopyrronium 320microgram/mL oral solution (Sialanar; equivalent to 400microgram/mL or 2mg/5mL glycopyrronium bromide), authorized for severe drooling in children and adolescents ≥3 years with chronic neurological disease, is now available. The NHS cost for 250mL bottle is £320. It is authorized for use via EFT and doses must be reduced in renal impairment. Due to lack of data the product is not authorized in adults or for long-term use.

A glycopyrronium bromide 200microgram/mL (1mg/5mL; Colonis Pharmaceuticals) oral solution, authorized for adults for the treatment of peptic ulceration is also available (see our news item 30th September 2016).

Glycopyrronium bromide
Tablets 1mg, 2mg, 28 days@ 1mg t.d.s. = £602.
Oral solution 1mg/5mL, 2mg/5mL 28 days @ 1mg t.d.s. = £255 or £269 respectively.
Injection 200microgram/mL, 1mL or 3mL amp = £1.20.

Note: other strengths of glycopyrronium bromide oral solution and oral suspension are also available as unauthorized products via special order 200micorgram/5mL, 500micorgram/5mL, 2.5mg/5mL, 5mg/5mL.

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