Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update – December 2009

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

This issue contains drug safety advice reminding clinicians that ciclosporin preparations should always be prescribed using a brand name due to the narrow therapeutic index of the drug and the variability that exists between brands. In addition, clinicians are informed of the potential risk of male breast cancer posed by finasteride. Patients taking this drug should be advised to report any changes in their breast tissue such as lumps, pain, or nipple discharge.

Readers are also informed of a future update to the prescribing information and patient information leaflets for warfarin. No new safety concerns have been identified but the information provided to clinicians and patients was found to be lacking in the following areas:

  • Timing of warfarin treatment after ischaemic stroke
  • Management of the patient before surgical or dental procedures
  • Patients at particular risk of haemorrhage
  • Interactions with herbal products, foods, and food supplements
  • Management of patients with significantly raised INR and/or haemorrhage

Finally, this issue contains the annual quiz that aims to test the knowledge of monthly readers. Answers are given at the end of the Update and sadly there are no prizes!

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

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