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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - October 2010

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

This issue advises clinicians of the replacement of Implanon® with Nexplanon®. The new product is different from Implanon because it comes in a pre-loaded device to reduce the risk of insertion errors and it is radio-opaque to allow easier location on x-ray or CT scan. Clinicians who currently insert this form of contraception should ensure they make themselves aware of the differences in the product and complete insertion training.

The Hot Topic section contains a review of the safety of the pandemic influenza (Pandemrix® and Celvapan®) and human papillomavirus (Cervarix®) vaccines. The safety profiles of the pandemic influenza vaccines were very much as expected with the most common side effects being injection site reactions and mild flu-like symptoms. The safety review of Cervarix pays particular attention to chronic fatigue syndrome, Guillain-Barr√© syndrome and encephalitis. In all three conditions the rate of cases in the population who were administered the vaccine is the same as the natural rate in an unvaccinated population.

The Stop Press section reminds clinicians of the recommendation that rosiglitazone (Avandia®, Avandamet®) be withdrawn from clinical use and warns of the risk of drug name confusion with mercaptamine and mercaptopurine. Mercaptamine is recommended for specialist use only in nephropathic cystinosis while mercaptopurine is an immunosuppressant used in leukaemias and inflammatory bowel disease [unlicensed]. The particular error that led to this warning arose in general practice.

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

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