Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - April 2015

The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.

Aclidinium / Formoterol Inhaler (Duaklir Genuair®) has been accepted for use as maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease.

Levonorgestrel IUD (Jaydess®) has been accepted for use as contraception for up to 3 years.

Tacrolimus prolonged release tablets (Envarsus®) have been accepted for the prophylaxis of transplant rejection in adult kidney or liver allograft recipients and treatment of allograft rejection resistant to treatment with other immunosuppressive medicinal products in adult patients. It is noted that this product has demonstrated non-inferiority to a tacrolimus immediate-release capsule and has a similar cost per equivalent dose.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.

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Rupatadine discontinued

The product license holder of rupatadine (Rupafin®) has written to healthcare professionals advising that with effect from the 31st March 2015 this medicine will be effectively discontinued in the UK.

An agreement between the license holder and a UK based distributor has come to an end and a new distributor is not being sought. It is estimated that supplies would be exhausted by the end of March 2015. As such alternative treatment options will need to be considered.

Action: Clinicians should be aware of the product being discontinued. It may be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow an alternative to be arranged.

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Drug Safety Update - March 2015

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for March 2015 (PDF). This month there are two updates pertinent to primary care.

A new e-learning module for corticosteroids has been created that aims to help clinicians understand how to identify, manage and avoid the
important side effects of these valuable and widely prescribed medicines - vital knowledge for optimising the use of corticosteroids.

Readers are also encouraged to report misleading medicines advertisements. Reports can be made to the MHRA at advertising@mhra.gsi.gov.uk or Prescription Medicines Code of Practice Authority (PMCPA) at complaints@pmcpa.org.uk.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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Creon 40,000 temporarily unavailable

The manufacturer of Creon has written to healthcare professionals advising that Creon 40,000 capsules are temporarily unavailable due to manufacturing yield problems.

A letter from the manufacturer notes that Creon is a biological product and lower than expected yields of high-potency enzymes from porcine glands has impacted on the current availability of the 40,000 strength product. This issue does not impact upon the lower dose products and therefore Creon 25,000 and 10,000 remain available.

It is therefore recommended that an equivalent dose of a lower dose be used with a preference to use the 25,000 strength product to reduce the number of capsules taken by individual patients.

Action: Clinicians should be aware of this supply issue. It may be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow a review and an alternative to be arranged.

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SMC Update - March 2015

The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.

Apixaban (Eliquis®) has been accepted for use in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and prevention of recurrent DVT and PE in adults.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.

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