Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - February 2012

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

Midazolam oromucosal solution (Buccolam®) has been accepted for use in the treatment of prolonged, acute, convulsive seizures in infants, toddlers, children and adolescents.

Prednisone modified release (Lodotra®) has been rejected in the absence of a submission for the treatment of moderate to severe, active rheumatoid arthritis.

Rivaroxaban (Xarelto®) has been accepted for restricted use in the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation with one or more risk factors. Treatment is restricted to individuals who have poor INR control despite evidence that compliance good or in individuals who are allergic to or unable to tolerate coumarin anticoagulants.

Rivaroxaban (Xarelto®) has been accepted for treatment of deep vein thrombosis (DVT), and prevention of recurrent DVT and pulmonary embolism following an acute DVT in adults.

Saxagliptin (Onglyza®) has been rejected in the absence of a submission in the treatment of type 2 diabetes mellitus to improve glycaemic control in combination with insulin (with or without metformin).

Tapentadol (Palexia®) has been rejected in the absence of a submission for the relief of moderate to severe acute pain in adults, which can be adequately managed only with opioid analgesics.

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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