☀️     🌓

Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Generic topiramate

The manufacturer of Topamax® (topiramate) has written to healthcare professionals advising that generic versions of this drug are likely to be available soon due to patent expiry. They also advised that current recommendations indicate that generic substitution should be avoided.

Similar action was taken by the manufacturer of lamotrigine when the patent expired. At this time the Department of Health reassured clinicians that prescribing generically was safe and effective. It is also notable that generic versions of lamotrigine are approximately 90% less expensive than the branded equivalent.

The letter contains references to the National Institute for Health and Clinical Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines for epilepsy. The NICE guideline suggests that "changing the formulation or brand of AED is not recommended" but this recommendation is rated as level D and is therefore derived from extrapolated data or expert opinion rather than hard clinical evidence. The SIGN guideline contains no indication for the level of evidence attributed to the similar recommendation in their guideline.

Action: Clinicians should continue to prescribe topiramate as generic. Prescriptions can be branded where this is felt to be clinically appropriate.

Share 'Generic topiramate' by emailShare 'Generic topiramate' on FacebookShare 'Generic topiramate' on TwitterShare 'Generic topiramate' on MastodonShare 'Generic topiramate' on LinkedInShare 'Generic topiramate' on reddit

Drug Safety Update - September 2009

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for September 2009 (PDF).

This issue contains Hot Topics on the possible association between insulin glargine and an increased risk of cancer, an update on the efficacy of measures implemented to reduce risk of illicit use of ephedrine and pseudoephedrine and information about the new warnings and tighter controls for codeine and dihydrocodeine containing analgesics.

Additionally, there is a Stop Press regarding the interaction between proton pump inhibitors and clopidogrel that clarifies alternative gastrointestinal therapies should not include cimetidine.

Action: Clinicians will find this publication to be a useful review of current issues in drug safety.

Share 'Drug Safety Update - September 2009' by emailShare 'Drug Safety Update - September 2009' on FacebookShare 'Drug Safety Update - September 2009' on TwitterShare 'Drug Safety Update - September 2009' on MastodonShare 'Drug Safety Update - September 2009' on LinkedInShare 'Drug Safety Update - September 2009' on reddit

OTC analgesic advice

The Medicines and Healthcare products Regulatory Agency has issued a press release (PDF) regarding new restrictions and package warnings for over the counter (OTC) analgesics that contain codeine or dihydrocodeine.

Packages and information leaflets will be revised to warn consumers about the risk of addiction and guidance on the use of these products will focus on treating moderate pain that is not relieved by simple painkillers such as paracetamol and ibuprofen.

Additionally, pharmacies will no longer be able to sell large packs of effervescent codeine-containing analgesics containing more than 32 tablets. Packs containing more than 32 tablets will become prescription only medicines (POMs). This step builds upon pack size restrictions introduced in 2005 that affected non-effervescent analgesics containing paracetamol.

Action: Clinicians should be aware of these new restrictions. Patients may request these analgesics on prescription to ease access to quantities greater than 32 tablets.

Share 'OTC analgesic advice' by emailShare 'OTC analgesic advice' on FacebookShare 'OTC analgesic advice' on TwitterShare 'OTC analgesic advice' on MastodonShare 'OTC analgesic advice' on LinkedInShare 'OTC analgesic advice' on reddit

Newer Posts »

Prescribing Advice for GPs is powered by ClassicPress.
Connect to our RSS or Atom Feeds.