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ISSUE 5 OCTOBER
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Subsidised palliative care medicines

The Pharmaceutical Benefits Scheme (PBS) website contains a new consolidated list of palliative care medications (see www.pbs.gov.au/html/healthpro/browseby/palliative-care). This list is for use in conjunction with the general PBS listings section, which also contains many drugs used in palliative care.

For the purposes of prescribing these medicines, a patient receiving palliative care is defined as 'a patient with an active, progressive, far-advanced disease for whom the prognosis is limited and the focus of care is the quality of life'.

All of the drugs on this list (see box) are 'Authority required'. Prescribers can request an initial authority for up to four months of treatment. When continuing treatment is required, the prescriber must confirm that a palliative care physician or palliative care service has been consulted about the care of the patient.

Authority approvals can be obtained by phoning 1800 888 333 for general benefits and 1800 552 580 for repatriation benefits.

Prescribers must heed state and territory laws when prescribing narcotic drugs and must notify, or receive approval from, the appropriate health authority.

When a palliative care authority application is for a drug of addiction, the following guidelines apply:

  • the maximum quantity authorised is generally for 1 month
  • where supply for a longer period is warranted, quantities are for up to 3 months
  • telephone approvals are limited to 1 month's therapy.

Doctors should also state (on the prescription) the interval of repeat where repeats are called for, and ensure state and territory health authorities are notified about ongoing treatment.

PBS listings as at 1 September 2008

Analgesics

morphine sulfate tablets (10 mg, 20 mg, 200 mg)
fentanyl lozenges (200, 400, 600, 800, 1200, 1600 microgram)
methadone hydrochloride oral liquid (25 mg/5 mL)
paracetamol suppositories (500 mg) and tablets (665 mg)

Antiemetics and antinauseants

promethazine hydrochloride oral liquid (5 mg/5 mL)
and tablets (10 mg and 25 mg)

Antiepileptics

clonazepam oral liquid (2.5 mg/mL) and tablets (500 microgram, 2 mg)

Anti-inflammatory and antirheumatic products

diclofenac sodium suppositories (100 mg) and tablets (25 mg, 50 mg)
indomethacin suppositories (100 mg) and capsules (25 mg)
sulindac tablets (100 mg, 200 mg)
ibuprofen tablets (200 mg, 400 mg)
naproxen tablets (250 mg, 500 mg, 750 mg, 1 g)
naproxen oral suspension (125 mg/5 mL)
naproxen sodium tablets (550 mg)

Drugs for functional gastrointestinal disorders

hyoscine butylbromide injection (20 mg/mL)

Laxatives

bisacodyl suppositories (10 mg) and tablets (5 mg)
sterculia with frangula bark granules (62% / 8%)
lactulose mixture (3.34 g/5 mL)
macrogol 3350 powder (13.125 g sachets)
bisacodyl enemas (10 mg/5 mL)
sorbitol with sodium citrate and sodium lauryl
sulfoacetate enemas (3.125 g/450 mg/45 mg in 5 mL)
glycerol suppositories (700 mg, 1.4 g, 2.8 g)

Psycholeptics

diazepam tablets (2 mg, 5 mg)
oxazepam tablets (15 mg, 30 mg)
nitrazepam tablets (5 mg)
temazepam tablets (10 mg)

Stomatological preparations

benzydamine hydrochloride mouth and throat rinse (22.5 mg/15 mL)
carmellose sodium mouth spray (10 mg/mL)