Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - October 2014

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

Alogliptin (Vipidia®) has been accepted for restricted use in the treatment of adults aged 18 years and older 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 dual therapy with metformin or a sulphonylurea. This treatment is not recommended as monotherapy or in triple therapy.

Alogliptin plus metformin (Vipdomet®) has been accepted for restricted use in the treatment of adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control. It can be used alone or in combination with pioglitazone or insulin. The restriction limits use to patients for whom this fixed dose combination of alogliptin and metformin is an appropriate choice of therapy.

Azelastine + Fluticasone (Dymista®) has been accepted for the relief of symptoms of moderate to severe seasonal and perennial allergic rhinitis if monotherapy with either intranasal antihistamine or glucocorticoid is not considered sufficient. This SMC advice is contingent upon the continuing availability of the Patient Access Scheme.

Capsaicin (Qutenza®) has been accepted for the treatment of peripheral neuropathic pain in non-diabetic adults either alone or in combination with other medicinal products for pain. The restriction limits use to patients who have not achieved adequate pain relief from, or have not tolerated, conventional first and second line treatments.

Dabigatran (Pradaxa®) has been accepted for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults.

Empagliflozin (Jardiance®) has been accepted for restricted use in the treatment of type 2 diabetes to improve glycaemic control in adults as add-on combination therapy: 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 the following situations:

  • dual therapy in combination with metformin, when a sulphonylurea is inappropriate
  • triple therapy in combination with metformin plus standard of care
  • add-on to insulin therapy in combination with insulin plus standard of care

Lurasidone (Latuda®) has been accepted for restricted use in the treatment of schizophrenia in adults aged 18 years and over. The restriction limits use to those patients in whom it is important to avoid weight gain and metabolic adverse effects.

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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