Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - June 2014

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

Avanafil (Spedra®) has been rejected for use in the treatment of erectile dysfunction in adult men. The manufacturer failed to make a submission but plans to make a submission in November 2014.

Budesonide granules (Budenofalk®) have been accepted for the induction of remission in patients with mild to moderate active Crohn’s disease affecting the ileum and/or ascending colon.

Canagliflozin (Invokana®) has been accepted for restricted use in adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control as add-on therapy 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 the following situations:

  • dual therapy in combination with metformin
  • triple therapy in combination with metformin plus standard of care
  • add-on to insulin therapy in combination with insulin plus standard of care

Fluticasone / vilanterol (Relvar Ellipta®) has been accepted for the regular treatment of asthma in adults and adolescents aged 12 years and older where use of a combination medicinal product (ICS/LABA) is appropriate. The review notes that some alternative ICS/LABA combination inhalers are available at a lower daily cost.

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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