Palliative care

These guidelines are based on the section, Prescribing in Palliative Care, in the introduction to the BNF, and the West Midlands Palliative Care Physicians (Palliative care - guidelines for the use of drugs in symptom control, 2003 (updated 2007, 2012, 2019)).

Useful palliative care resources include (1):

British National Formulary

Guidance on prescribing in palliative care in the British National Formulary (BNF) and BNF for Children (BNFC) includes advice on:

• pain management, including equivalent doses of opioid analgesics
• symptom control, such as dry mouth, dyspnoea, hiccup, nausea and vomiting
• continuous subcutaneous infusions, including compatibility with diamorphine

BNFC guidance includes a link to the Association for Paediatric Palliative Medicine (APPM) master formulary.

APPM master formulary

The APPM master formulary provides guidance on medicines use in paediatric palliative care. The formulary is a 276-page pdf document that can be downloaded or viewed online.

Information is presented as:

• drug monographs, which include dosage information and key practice points
• appendices, such as morphine equivalent doses, subcutaneous infusion drug compatibility and switching from gabapentin to pregabalin in children with neuropathic pain

NHS Scotland Palliative Care Guidelines

The Scottish Palliative Care Guidelines for adults are freely available. They contain sections on:

• pain
• symptom management
• palliative emergencies
• medicine information – individual drug monographs, listed alphabetically
• anticipatory prescribing
• syringe pump or driver guidelines
• last days of life
• out of hours handover
• health and social care resources
• patient information – printable leaflets for specific medicines

End of life guidance for diabetes care

End of life guidance for diabetes care, endorsed by Diabetes UK, provides useful advice on managing diabetes in the last year, month and days of life.

The summary of product characteristics must be consulted before prescribing drugs detailed in this section.

Reference:

1. NHS Specialist Pharmacy Service (March 2026). Palliative care: useful resources to support clinical decisions