Standardised Strengths of Unlicensed Liquid Medicines for Children – RCPCH & NPPG Joint Position Statement

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The Royal College of Paediatrics & Child Health (RCPCH) and the Neonatal & Paediatric Pharmacists Group (NPPG) have published a joint position statement on Using standardised strengths of unlicensed liquid medicines in children.

The joint statement strongly recommends that when children require unlicensed liquid medications, they should receive the RCPCH and NPPG recommended strength, where one exists. The RCPCH assert that standardising the prescribed strengths of unlicensed specials for children will reduce the risk of dose errors being made, prevent hospitalisation from accidental under and overdoses and enable quality improvements:

“Every year there is harm to patients caused by accidental under and overdosing of medicines in children solely due to the fact that the strength of their liquid medication changed and the person administering the medicine did not realise they needed to change the volume. Furthermore there is a strong desire to improve the quality and control the cost of this group of medications which still form a large proportion of the medicines supplied to children. It will be difficult to progress these quality improvements without first standardising the strength.”

The joint statement lists recommended strengths for 14 unlicensed specials – based on research published in Arch Dis Child Educ Pract Ed in 2018, predetermined safety and practicality criteria and a structured Delphi review of experts. The recommended strengths can also be found in the BNFC monographs for each of the drugs & via the Paediatric Care Online UK website.

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