Following a review of medicines for palliative care by the Expert Committee in 2013, hyoscine butylbromide was added to the core list of the EML for management or respiratory secretions in patients receiving palliative care. Although the evidence for the benefit to the patient of the use of antimuscarinic agents in prevention of accumulation of respiratory tract secretions during the dying phase was acknowledged as weak by the Expert Committee, the inclusion of hyoscine butylbromide (which, in contrast to the hydrobromide included for children, does not cross the blood-brain barrier) was supported.