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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - August 2010

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

Betamethasone medicated plaster (Betesil®) has been rejected for the treatment of inflammatory skin disorders which do not respond to treatment with less potent corticosteroids. The economic analysis was not sufficiently robust.

Aripiprazole (Abilify®) has been accepted for restricted use for the treatment of schizophrenia in adolescents 15 years and older. A child/adolescent psychiatrist should initiate and supervise management.

Dutasteride / tamsulosin (Combodart®) has been accepted for treatment of moderate to severe symptoms of benign prostatic hyperplasia (BPH) and to reduce the risk of retention or surgery in patients with moderate to severe symptoms of BPH in whom concomitant use of these medicines is appropriate.

Sitagliptin / metformin (Janumet®) has been accepted for use in combination with a sulphonylurea (i.e. triple therapy) an adjunct to diet and exercise in patients with type 2 diabetes who are inadequately controlled on maximal tolerated doses of metformin and a sulphonylurea.

Indacaterol (Onbrez Breezhaler®) has been accepted for maintenance bronchodilator treatment of airflow obstruction in adult patients with chronic obstructive pulmonary disease (COPD). The review notes that indacterol was superior in improving lung function (FEV1) compared to other long-acting bronchodilators at 12 weeks follow up, however other agents are available at lower cost.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.

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