Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - March 2014

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

Alogliptin (Vipidia®) has been rejected for use in adults with type 2 diabetes mellitus to improve glycaemic control in combination with other glucose lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. The manufacturer did not present sufficiently robust clinical and economic analysis to gain acceptance.

Dapagliflozin (Forxiga®) has been accepted for restricted use in adults with type 2 diabetes mellitus to improve glycaemic control in combination with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. The restriction limits use to combination with insulin, when insulin with diet and exercise, does not provide adequate glycaemic control.

Insulin degludec (Tresiba®) has been rejected for the treatment of diabetes mellitus in adults. The manufacturer did not present a sufficiently robust economic analysis to gain acceptance

Saxagliptin (Onglyza®) has been rejected for use as monotherapy in adult patients with type 2 diabetes mellitus to improve glycaemic control inadequately controlled by diet and exercise alone and for whom metformin is inappropriate due to contraindications or intolerance. The manufacturer failed to make a submission.

Solifenacin and tamsulosin (Vesomni®) has been accepted for the treatment of moderate to severe storage symptoms (urgency, increased micturition frequency) and voiding symptoms associated with benign prostatic hyperplasia in men who are not adequately responding to treatment with monotherapy.

Zonisamide (Zonegran®) has been accepted for restricted use as adjunctive therapy in the treatment of partial seizures, with or without secondary generalisation, in adolescents and children aged 6 years and above. The restriction limits use only when advised by specialists (paediatric neurologists or paediatricians with an expertise in epilepsy).

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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