Prescribing Advice for GPs

MeReC Bulletin on Dyspepsia

April 7, 2006 on 9:31 am | In Prescribing Extra - Other |  Print | No Comments

The National Prescribing Centre has published a MeReC Bulletin detailing the initial management of dyspepsia in primary care.

This Bulletin is very similar to the recently covered MeReC Briefing on the same topic. However, several other resource materials have also been made available with the Bulletin. These include:

• a summary of the NICE Dyspepsia Guideline
• a presentation based on the NICE Dyspepsia Guideline
• a list of additional resources
• some questions and answers to test understanding for Continuing Professional Development (CPD)

Action: Clinicians involved in the diagnosis and treatment of dyspepsia will find the extra resources provided with this bulletin are useful additions to the original MeReC Briefing.

PPI Price Update

April 4, 2006 on 3:58 pm | In Prescribing Extra - Drugs |  Print | No Comments

The Drug Tariff for April 2006 has updated the price of Omeprazole, a Proton Pump Inhibitor (PPI).

As previously reported, Lansoprazole is now generic and there was a favourable cost difference when compared to other PPIs, including omeprazole. This difference caused issues in areas where PPI switches from lansoprazole to omeprazole had recently occurred. Caution was suggested in changing these patients back to lansoprazole.

The April prices for Omeprazole have been reduced and the Lansoprazole prices remain unchanged. As such, the cost difference is not as much of a concern.

Current PPI Prices are as follows:

• Lansoprazole 15mg - £4.57
• Lansoprazole 30mg - £6.73
• Omeprazole 10mg - £5.32
• Omeprazole 20mg - £8.94

Action: Lansoprazole is the PPI of choice and Omeprazole is an obvious second choice. There is no reason to switch between these therapies on the basis of cost alone.

MeReC Bulletin on NICE

April 4, 2006 on 12:24 pm | In Prescribing Extra - Other |  Print | No Comments

The National Prescribing Centre has published a MeReC Bulletin answering some common question about the organisation and function of the National Institute of health and Clinical Excellence (NICE).

There are also three supplements covering:

• topic selection and guidance development
• implementation resources
• information sources in the absence of NICE guidance

The MeReC Bulletin provides an overview of the history of NICE, it’s current function, guidance dissemination, legal status of the guidance and implementation.

Action: NICE Guidance is far reaching in the NHS. All clinicians would benefit from reading this bulletin.

BNF 51

April 3, 2006 on 11:14 am | In Prescribing Extra - Other |  Print | No Comments

The 51st Edition of the British National Formulary is currently being printed and distributed.

Priority is given to the print version before the web version is updated.

The print version is distributed by the Department of Health to Dentists, Doctors, Nurses and Pharmacists providing NHS services.

Action: All clinicians should start using BNF 51 as soon as the print version arrives.

EMEA recommends caution with newer Eczema creams

April 1, 2006 on 9:13 am | In Prescribing Extra - Drugs |  Print | No Comments

The European Medicines Agency (EMEA) has recommended that Tacrolimus (Protopic)^® and Pimecrolimus (Elidel)^® should be used with greater caution.

Following a review of the safety of these products the EMEA concluded that the benefits outweigh the risks but that greater caution should be used when prescribing in order to reduce potential risks of skin cancer and lymphoma.

Changes in the product information have been recommended to warn patients and prescribers about the potential risks of these treatments. Additionally, prescribers are reminded that these products:

• should only be initiated by clinicians with experience of diagnosis and treatment of atopic dermatitis
• should not be used in children under 2 years old
• should only be used when a topical corticosteroid should not or cannot be used
• should be applied sparingly, at the lowest effective dose for the shortest possible duration
• should not be used long term or continuously

Further information is contained in the question and answer document on the EMEA website.

Action: Clinicians should be aware of these recommendations and ensure they are implemented.