Carbamazepine interaction with DOACs

20th February 2018

The SPC for all formulations of carbamazepine has been updated to highlight the risk of interaction when carbamazepine is used concomitantly with direct acting oral anti-coagulants (DOACs) e.g. apixaban, dabigatran, edoxaban, rivaroxaban. Carbamazepine may reduce plasma concentrations of DOACs, thus risking thrombosis.

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Retirement lunch for Robert Twycross

14th February 2018

Following the announcement of his retirement as joint Editor-in-Chief of the Palliative Care Formulary, (see our news item), a retirement luch was held for Robert Twycross. A personalized leather-bound copy of PCF6 and IPC5 were presented, along with an engraved pen set and words of appreciation/anecdotes provided by members of palliative.drugs.com. Photographs were taken to mark the occasion. In the picture below, from left to right are:

Back row: Dr Claire Stark-Toller (PCF6 Editor), Dr Andrew Wilcock (PCF6 Editor-in-Chief), Dr Robert Twycross (PCF6 Editor-in-Chief), Dr Paul Howard (PCF6 Editor-in-Chief), Sarah Charlesworth (PCF6 Senior Editor)

Front row: Sarah Keeling (Production editor), Karen Isaac (Secretary), Julie Mortimer (PCF6 Associate Editor).

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Cochrane review: bisphosphonates and other bone agents for breast cancer

14th February 2018

In this review, the authors concluded that for women with early breast cancer, bisphosphonates reduce the risk of bone metastases and provide an overall survival benefit compared to placebo or no bisphosphonates. In postmenopausal women, preliminary evidence suggests that bisphosphonates may provide an overall survival and reduced risk of cancer returning, however new trials in postmenopausal women are still underway.

For women with metastatic breast cancer that has spread to the bone, bisphosphonates reduce the risk of developing skeletal related events (SREs), delay the median time to an SRE, and appear to reduce bone pain compared to placebo or no bisphosphonate.

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Fencino TD patches and crystal formation

13th February 2018

A letter has been sent by Ethypharm to health professionals explaining the observed presence of crystals on some Fencino (fentanyl) transdermal patches. The crystals are embedded in the matrix, do not break off by themselves and there is no evidence that they cause skin irritation or any safety concerns.

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Hyoscine butylbromide ampoules (Buscopan) shortage - UPDATE

6th February 2018

There is a national shortage of hyoscine butylbromide injection (Buscopan) in the UK, as Sanofi (the sole supplier of this product) is out of stock. New supplies are expected by the end of this week (5th February 2018). However, some units have already run out of stock. Glycopyrronium injection can be considered as an unauthorized alternative in the palliative care seting for the management of inoperable intestinal obstruction or as an antispasmodic. See PCF6 Antimuscarinics and PCF6 Glycopyrronium monographs for more detail.

08/02/18 Update

Sanofi have confirmed that supplies of hyoscine butylbromide injection (Buscopan) have now been released and stock has been delivered to wholesalers throughout the UK on the 7^th and 8^th February 2018. It should be available for ordering within 24h. They have advised that the available volume is sufficient to meet normal UK requirements and that there should be no further delays to future delivery schedules. In order to prevent further strain on the supply chain they have asked that people refrain from excess ordering.

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Tramadol/dexketoprofen combination product available

6th February 2018

A new combination immediate-release tablet containing the weak opioid tramadol 75mg and NSAID dexketoprofen 25mg (Skudexa) has been launched.

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