Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC latest advice

The Scottish Medicines Consortium (SMC) has issued new guidance on several medicines including rejecting Glyceryl Trinitrate 0.4% Ointment (Rectogesic)® for use on the NHS in Scotland for a third time and restricting the place of pioglitazone (Actos®) in triple therapy.

As previously discussed, Glyceryl Trinitrate 0.4% Ointment has been rejected after failing to make a robust economic case supporting its use on the NHS. The SMC have upheld this previous guidance after a resubmission. First line treatment of anal fissures remains focused upon lifestyle advice about diet and bowel habit.

The SMC has also reviewed the place of pioglitazone in triple oral therapy for type 2 diabetes where glycaemic control is not optimal despite dual therapy treatment. It is advised that the triple therapy approach is reserved for patients unable or unwilling to take insulin.

Action: Clinicians should be aware of this latest advice and ensure that the recommendations are adopted into current practice.

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