Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - June 2016

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

Co-careldopa intestinal gel (Duodopa®) has been accepted for restricted use in the treatment of advanced levodopa-responsive Parkinson's disease with severe motor fluctuations and hyper-/dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results. The restriction limits use to patients who are not eligible for deep brain stimulation.

Evolocumab (Repatha®) has been rejected for use:

  • in adults with primary hypercholesterolaemia
  • in combination with a statin or statin with other lipid lowering therapies in patients unable to reach low density lipoprotein-cholesterol (LDL-C) goals
  • alone or in combination with other lipid-lowering therapies in patients who are statin-intolerant, or for whom a statin is contraindicated
  • in adults and adolescents aged 12 years and over with homozygous familial hypercholesterolaemia in combination with other lipid-lowering therapies

The submitting company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC.

Febuxoxtat (Adenuric®) has been accepted for restricted use in the prevention and treatment of hyperuricaemia in adult patients undergoing chemotherapy for haematologic malignancies at intermediate to high risk of Tumour Lysis Syndrome (TLS). The restriction limits use to patients in whom allopurinol is either unsuitable or contraindicated.

Naproxen effervescent tablets (Stirlescent®) have been accepted for restricted use in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute musculoskeletal disorders, dysmenorrhoea and acute gout in adults. The restriction limits use to patients who are unable to swallow naproxen tablets.

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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