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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - January 2010

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for January 2010 (PDF).

This issue contains drug safety advice informing clinicians of an increased risk of Stevens-Johnson syndrome in genetically predisposed individuals of Thai or Han Chinese ethnic origin who take phenytoin. Clinicians should avoid using phenytoin in individuals who are known to be HLA-B*1502 positive but routine genetic screening is not currently recommended.

There is also a hot topic reviewing the use of methylphenidate in attention-deficit hyperactivity disorder (ADHD). Patient information leaflets are being updated to include the latest guidance on safe and effective use for patients and carers. Clinicians are reminded that:

  • Treatment with methylphenidate should be supervised by a specialist
  • Diagnosis should be made according to DSM-IV criteria or ICD-10 guideline
  • Children and adolescents should have rigorous pre-treatment screening
  • Patients should be monitored regularly during treatment including: blood pressure and pulse; height, weight, and appetite; onset or worsening of psychiatric symptoms and symptoms suggestive of heart disease
  • Treatment should be interrupted at least yearly to determine whether continuation is needed

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

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