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Cochrane review: olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults

26th September 2018

In this review, the authors concluded that oral olanzapine probably increases the likelihood of not being nauseous or vomiting during chemotherapy from 25% to 50% in adults with solid tumours, in addition to standard therapy, compared to placebo or no treatment.

There is uncertainty whether it increases serious undesirable effects. It may increase the likelihood of other undesirable effects, e.g. somnolence and fatigue. There is uncertainty about relative benefits and harms of 5mg versus 10mg.

Only RCTs describing oral administration were found. The authors noted that the findings of this review cannot be extrapolated to provide evidence about the efficacy and safety of any injectable form (intravenous, intramuscular or subcutaneous) of olanzapine.

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Lorazepam 4mg/mL injection shortage

18th September 2018

Pfizer is currently experiencing supply problems with lorazepam (Ativan) 4mg/mL injection in the UK. It is anticipated that there may be limited supply and stock restrictions until late October 2018. There is no other alternative authorized UK supplier.

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Diamorphine 5mg and 10mg injection

18th September 2018

Diamorphine 5mg and 10mg injection are now available again to order from UK wholesalers. The supply shortage that has existed since May 2018 has now been resolved. However, to prevent a recurrence, units have been asked not to stockpile.

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Cannabis-derived medicinal products: update

18th September 2018

Following the Chief Medical Officer for England’s report (see our news item 11 July 2018), the Advisory Council on the Misuse of Drugs (ACMD) was commissioned by the Home Secretary to consider the appropriate scheduling of cannabis-derived medicinal products. Their response was published on 19 July 2018 and forms part of the government review.

ACMD recommendations 

In the interim, an expert panel has been established to consider licence applications for the use of cannabis and cannabis-based medicinal products, in exceptional cases, where there is unmet clinical need.

Government review

Note. The PCF cannabinoids monograph has been updated on-line this month and summarizes the current evidence in palliative care and reflects the current supply situation.

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CQC annual report: safer management of controlled drugs

13th September 2018

The UK Care Quality Commission (CQC) has published their 2017 annual report on the safer management of controlled drugs. The following four recommendations have been added to the existing guidelines:

1. Prescribers should ask patients about their existing prescriptions and current medicines when prescribing controlled drugs. Where possible, prescribers should also inform the patient’s GP to make them aware of treatment to minimise the risk of overprescribing that could lead to harm.

2. Commissioners of health and care services should include the governance and reporting of concerns around controlled drugs as part of the commissioning and contracting arrangements so that these are not overlooked.

3. Health professionals should keep their personal identification badges and passwords secure and report any losses as soon as possible to enable organisations to take the necessary action.

4. Health and care staff should consider regular monitoring and auditing arrangements for controlled drugs in the lower schedules, such as Schedules 4 and 5, to identify and take swift action on diversion.

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T34 syringe pumps updated safety warning

7th September 2018

CME Ltd have published an updated Field Safety Notice specifying the brand of battery that should be used in T34 syringe pumps, along with precautionary measures, to ensure adequate connection and functioning.

The recommended battery for the T34 syringe pump is Duracell® brand 9-volt (6LR61) battery.

This follows the MHRA Safety Alert in April 2018 regarding the possible loss of function due to the battery connection from different battery brands (see our news item).

The Association of Palliative Medicine (APM) has also produced a joint statement with the MHRA highlighting the issue.

CME updated Field Safety Notice

MHRA and APM Statement


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APM position statement on opioids

6th September 2018

The Association of Palliative Medicine has published a position statement on the use of opioids in response to the Gosport report.

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