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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update

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

Lumiracoxib (Prexige)® has been accepted for use on the NHS in Scotland for patients where a COX-II Inhibitor is appropriate. Lumiracoxib should not be used in patients with established cardiovascular disease (including ischaemic heart disease, cerebrovascular disease, peripheral arterial disease and moderate or severe congestive heart failure).

Sildenafil (Revatio) has been restricted to use in patients with pulmonary artery hypertension (PAH) classified as WHO functional class III to improve exercise tolerance. The Summary of Product Characteristics recommends that treatment with this drug should be initiated and monitored by a physician experienced in the treatment of pulmonary arterial hypertension. This would appear to restrict prescribing to secondary care settings at the present time.

Action: Clinicians should be aware of the recommendations of the SMC. As already discussed, the place in therapy for lumiracoxib is likely to be very restricted. The use of sildenafil for PAH appears to be restricted to secondary care.

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