• Joint Formulary Committee (2020) British National Formulary.
Available at:

• Palliative Care Formulary. Available at:


• Klepstadt P, Kassa S, Borchgrevink PC. “Starting step III opioids for moderate to severe pain in cancer patients: Dose titration: A systematic review” Palliat Med. 2011; 25(5): p424-430

• Evidence on the analgesic role of bisphosphonates and denosumab in the treatment of pain due to bone metastases: A systematic review within the European Association for Palliative Care guidelines project. Porta-Sales J, et al. Palliat Med. 2016 Mar 22. pii: 0269216316639793. [Epub ahead of print]


This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.

While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.