Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - May 2017

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for May 2017 (PDF).

This issue contains information about an association between finasteride 1mg and depression and, in rare cases, suicidal thoughts. Finasteride is used for male pattern baldness at a dose of 1mg daily and for benign prostatic hyperplasia at 5mg daily. It is therefore recommended that patients taking finasteride 1 mg are advised to stop this medication and inform a healthcare professional should they develop symptoms of depression.

This issue also signposts a new set of free e-learning modules to find out more about how and when to report suspected adverse drug reactions. Doctors completing these modules will also earn CPD credits.

There is also a summary of letters sent to healthcare professionals in April including a reminder that retigabine (Trobalt®) has been withdrawn and will not be available from the end of June 2017. Other letters include a warning of the risk of medication errors with oral solution presentations of levetiracetam and a change to dosing recommendations for Amoxil® in patients undergoing haemodialysis.

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

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NICE Guidance - May 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of May 2017. This month there are two guidelines that impact upon primary care.

The Type 2 diabetes in adults guideline covers the care and management of type 2 diabetes in adults (aged 18 and over). It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels and identifying and managing long-term complications. It has been updated to include sodium–glucose cotransporter 2 (SGLT-2) inhibitors in the section on drug treatment and the algorithm for blood glucose lowering therapy has been also updated to include these treatment options.

The Eating disorders: recognition and treatment guideline covers the assessment, treatment, monitoring and inpatient care for children, young people and adults with eating disorders. It aims to improve the care people receive by detailing the most effective treatments for anorexia nervosa, binge eating disorder and bulimia nervosa. The guideline includes recommendations on identifying eating disorders.

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

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SMC Update - May 2017

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

Liraglutide (Saxenda®) has been rejected for use as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adult patients with an initial Body Mass Index of:

  • ≥30kg/m2 (obese)
  • ≥27kg/m2 and <30kg/m2 (overweight) with at least one weight-related comorbidity such as dysglycaemia (pre-diabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia or obstructive sleep apnoea

The manufacturer failed to make a submission.

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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CKS Updates - April 2017

During April 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The topics have undergone minor restructures. The most significant change is that the recommendations on primary care management and referral for Dyspepsia, including the management of severe oesophagitis, have been updated in line with the National Institute for Health and Care Excellence (NICE) clinical guideline and the lower age limit has been changed from 16 to 18 years.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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NICE Guidance - April 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of April 2017. This month there are two guidelines that impact upon primary care.

The Irritable bowel syndrome in adults clinical guideline covers diagnosing and managing irritable bowel syndrome (IBS) in people aged 18 and over. It has been updated in line with more recent guidance on recognition and referral for suspected cancer.

The Alcohol-use disorders clinical guideline covers care for adults and young people with physical health problems that are completely or partly caused by an alcohol-use disorder. It has been updated after an evidence review regarding corticosteroid treatment for people with severe alcohol-related hepatitis.

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

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