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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - May 2021

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of May 2021. This month are three guidelines and one technology appraisal that impact upon primary care.

The Heavy menstrual bleeding: assessment and management guideline has been updated. It covers assessing and managing heavy menstrual bleeding (menorrhagia). It aims to help healthcare professionals investigate the cause of heavy periods that are affecting a woman’s quality of life and to offer the right treatments, taking into account the woman's priorities and preferences. The update reinstated recommendations on the use of ulipristal acetate (Esmya®) for uterine fibroids in line with updated MHRA safety advice on the risk of serious liver injury.

The Epilepsies: diagnosis and management guideline has been updated. It covers diagnosing, treating and managing epilepsy and seizures in children, young people and adults in primary and secondary care. It offers best practice advice on managing epilepsy to improve health outcomes so that people with epilepsy can fully participate in daily life. The update reviewed and amended recommendations on carbamazepine, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, topiramate and zonisamide in line with the MHRA updated safety advice on antiepileptic drugs in pregnancy.

The Headaches in over 12s: diagnosis and management guideline has been updated. It covers advice on the diagnosis and management of tension-type headache, migraine, cluster headache and medication overuse headache in young people (aged 12 years and older) and adults. It aims to improve the recognition and management of headaches, with more targeted treatment to improve the quality of life for people with headaches, and to reduce unnecessary investigations. The update amended our recommendation on topiramate for migraine prophylaxis to include discussion of the potential benefits and risks, and the importance of effective contraception for women and girls of childbearing potential when taking topiramate.

The Crisaborole for treating mild to moderate atopic dermatitis in people 2 years and older technology appraisal has been terminated. This treatment is intended for use in the treatment of mild to moderate atopic dermatitis in people 2 years and older. However, the manufacturer withdrew its evidence submission and therefore no recommendation can be made at this time.

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

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