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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - January 2019

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

Tiotropium (Spiriva Respimat®) has been accepted for use as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year.

Ertugliflozin (Steglatro®) has been accepted for restricted use in adults aged 18 years and older with type 2 diabetes mellitus as an adjunct to diet and exercise to improve glycaemic control:

  • As monotherapy in patients for whom the use of metformin is considered inappropriate due to intolerance or contraindication.
  • In addition to other medicinal products for the treatment of diabetes

The restriction limits use as monotherapy to patients who would otherwise receive a dipeptidyl peptidase-4 inhibitor and in whom a sulphonylurea or pioglitazone is not appropriate.

Semaglutide (Ozempic®) has been accepted for restricted use in the treatment of adults with insufficiently controlled type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise when used in addition to other medicinal products for the treatment of diabetes. The restriction limits this drug to add on use only as the submission from the manufacturer did not relate to use as monotherapy when metformin is considered inappropriate.

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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