Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - June 2013

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

Linaclotide (Constella®) has been accepted for restricted use in the symptomatic treatment of moderate to severe irritable bowel syndrome with constipation (IBS-C) in adults. The restriction limits use to patients who have not responded adequately to or cannot tolerate all other suitable treatment options.

Saxagliptin and Metformin (Komboglyze®) has been accepted for restricted use to improve glycaemic control in adult patients aged 18 years and older with type 2 diabetes mellitus inadequately controlled on their maximally tolerated dose of metformin alone or those already being treated with the combination of saxagliptin and metformin as separate tablets. The restriction limits use to patient in whom the combination of saxagliptin and metformin is an appropriate choice and the addition of a sulphonylurea is considered inappropriate.

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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Influenza immunisation programme 2013/14

The Chief Operating Officer at the Department of Health (DH) has written to colleagues within the NHS to provide details of the recommended influenza immunisation programme for 2013/14.

The letter notes that the last flu season was quiet in England however other countries experienced more severe flu. As flu can be dangerous and is unpredictable it is hoped that vaccination rates will continue to improve. The letter also advises that an updated Seasonal flu plan for 2013/14 will be available soon.

The letter also contains several Annexes that cover the following areas:

  • Groups recommended to receive flu vaccine
  • GP practice checklist
  • Pregnant women
  • Health and social care workers
  • Improving uptake and data collections
  • Vaccine virus strains and available vaccines
  • Vaccine supply and strategic reserve
  • Contractual arrangements, service reviews and funding
  • Summary of planned changes to the immunisation schedule in 2013/14

Vaccine uptake aspirations are also set as:

  • reaching or exceeding 75% uptake for people aged 65 years and over
  • reaching or exceeding 75% uptake for people under 65 years in clinical risk groups, including pregnant women

Action: Clinicians should be aware of the target vaccination groups and the uptake aspirations.

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NovoFine 12mm needles to be discontinued

The manufacturer of NovoFine insulin needles has written to healthcare professionals advising that the 12mm 28G needle will be discontinued with effect from November 2013.

The motivation for this decision is to encourage use of their newer needles with improved design features. Possible alternatives in the range are:

  • NovoTwist 5mm 32G
  • NovoFine 6mm 31G
  • NovoFine 8mm 30G
  • NovoFine Autocover 8mm 30G

It should be noted that 12mm needles remain available from other manufacturers.

Action: Clinicians should be aware of the product being discontinued. It may be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow an alternative to be arranged.

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