The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for August 2013 (PDF).
This issue contains drug safety advice reminding clinicians that nitrofurantoin is contraindicated in patients with a creatinine clearance of less than 60ml/min. It is recommended that clinicians are aware of the current renal function when prescribing nitrofurantoin, especially for elderly patients.
The hot topic section reminds clinicians should not prescribe oral ketoconazole for fungal infections because the risk of liver injury outweighs benefits. Topical formulations are unaffected by this advice. Any patient currently taking ketoconazole orally for fungal infections should be reviewed and treatment stopped or an appropriate alternative issued. This section also contains a summary of the recently issued European Medicines Agency advice recommending that the dose and duration of use for metoclopramide is restricted because of neurological side effects.
This issue also contains information that the SSRI Learning Module has been updated to include information about QT interval risk and that a public consultation has been opened into the continued availability of oral diclofenac for purchase in pharmacies as a Pharmacy (P) medicine. This consultation will not affect topical products or the availability of diclofenac on prescription.
Action: Clinicians will find this publication to be a useful review of current issues in drug safety.