Supplementary information on cannabis-based products for medicinal use

22nd November 2018

Supplementary information has been published to clarify the status of the recent NHS England guidance to clinicians that was published on 31 October 2018 (see our news item) and provide clarification surrounding synthetic cannabinoids for medicinal use, e.g. dronabinol and nabilone.

NHS England Supplementary information

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Report on action taken on ambulatory syringe drivers

22nd November 2018

The UK government has produced a report reviewing the action taken since the 2010 Safety Alert ‘Safer ambulatory syringe drivers’. This Alert highlighted safety concerns with Graseby syringe drivers and required organisations to put in place a plan within a year to discontinue their use and transition to safer ambulatory syringe drivers within five years.

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NICE consultation on cannabis-based products for medicinal use

20th November 2018

Comments are now being sought on the draft scope for the NICE guidance on cannabis-based products for medicinal use. The consultation closes on 4 December 2018.

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Guidance and information on prescribing and supply of cannabis-based products for medicinal use

6th November 2018

Guidance is now available to help health professionals with the prescribing and supply of cannabis-based products for medicinal use, which were rescheduled in England, Wales and Scotland on the 1 November 2018 from Schedule 1 to Schedule 2 (see our previous news item).

Cannabis-based products for medicinal use: Guidance to clinicians (NHS England)

Guidance on the supply, manufacture, importation and distribution of unlicensed cannabis-based products for medicinal use in ‘specials’ (MHRA)

Interim clinical guidelines have also been produced by the Royal College of Physicians (RCP) and the British Paediatric neurology Association (BPNA), to support prescribing decisions.

RCP interim guidance

BPNA interim guidance

Finally, information for patients and the public is available on the NHS website.

Editor’s notes

Also see the recently updated PCF Cannabinoids, which reflects and was used to help inform the RCP guidance for use in palliative care.

The legislative changes do not apply to;

• synthetic versions of naturally occurring cannabinoids e.g. dronabinol (not UK)
• chemically synthesized derivatives e.g. nabilone
• Sativex^® (an authorized product in Schedule 4).

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Instanyl (fentanyl) multidose nasal sprays discontinued

6th November 2018

Takeda UK is discontinuing all strengths of Instanyl^® (fentanyl citrate) multidose nasal sprays on the 14^th December 2018 for commercial reasons.

The single dose Instanyl^® products (50micorgram/mL, 100microgram/mL and 200micorgram/mL) will remain available.

Alternative transmucosal fentanyl citrate products are available including, sublingual (Abstral^®) and buccal (Effentora^®) tablets, a lozenge with oromucosal applicator (Actiq^®) and a nasal spray (Pecfent^®). However, these products are not interchangeable on a microgram per microgram basis from one product to another and patients must undergo full titration if switching to a new product.

See the PCF Fentanyl (transmucosal) monograph and individual SPCs for details.

Letter to healthcare professionals

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