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Association for Paediatric Palliative Medicine Master Formulary

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Paediatric palliative medicine is characterised by use of medicines that are off licence or off label. Most indications and doses of medicines used in paediatric palliative medicine are derived from anecdotal evidence and involve scaled down adult doses.  


The APPM Master Formulary is a single standardised reference formulary, which is now acknowledged nationally and internationally as the standard reference formulary for paediatric palliative care.


The Master Formulary for Paediatric Palliative Medicine provides information on indications, routes and standardised doses for paediatric palliative medicine based on systematic literature review and appraisal of available research evidence together with expert consensus opinion where there is insufficient research evidence.  The formulary is available as a downloadable PDF and also as a component of the West Midlands Paediatric Palliative Care toolkit.


The APPM Master formulary has been widely publicised within the UK and Internationally.  The formulary is regularly updated with the third (2105) edition launched in November 2014.

Suggestions for further implementation

The APPM Master formulary provides significant additional information and guidance not found in the BNF for Children. This information needs to be widely available and accessible for all healthcare professionals caring for children with life threatening and life limiting conditions.

Challenges and learning

Production of the APPM Master Formulary would not be possible without funding for dedicated pharmacy support. Updating and peer review is incredibly important and time consuming.

Quality assurance/MHRA registration

Extensively peer reviewed by professionals from the UK and abroad and endorsed by Association for Paediatric Palliative Medicine and Together for Short Lives.