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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Additional NICE Guidance - March 2019

The National Institute of Health and Care Excellence (NICE) have published additional new or updated guidance for the month of March 2019. There are two additional guidelines that impact upon primary care.

The Lung cancer: diagnosis and management guideline has been updated. It covers diagnosing and managing non-small-cell and small-cell lung cancer. It aims to improve outcomes for patients by ensuring that the most effective tests and treatments are used, and that people have access to suitable palliative care and follow-up. The new recommendations supplement the existing recommendations on diagnosis, treatment and palliative care.

The Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes technology appraisal has been published. Ertugliflozin is recommended for use as monotherapy when metformin is contraindicated or not tolerated, when diet and exercise alone do not provide adequate glycaemic control, only if:

  • a dipeptidyl peptidase 4 (DPP‑4) inhibitor would otherwise be prescribed and
  • a sulfonylurea or pioglitazone is not appropriate

It is also recommended for use as an option in combination with metformin to improve glycaemic control, only if:

  • a sulfonylurea is contraindicated or not tolerated or
  • the person is at significant risk of hypoglycaemia or its consequences

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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