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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - December 2022

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

Micronised progesterone (Utrogestan®) has been accepted for adjunctive use with oestrogen in post-menopausal women with an intact uterus, as hormone replacement therapy (HRT). This product provides an additional treatment choice in the therapeutic class of progestogens.

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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Drug Safety Update - December 2022

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for December 2022 (PDF).

This issue reminds clinicians about the ongoing Pregnancy Prevention Programme for Valproate medicines. Data show ongoing exposure to valproate in pregnancy and although use has declined, levels appear to have plateaued. As such, the Commission on Human Medicines (CHM) has advised new safety measures for valproate-containing medicines that are to be put in place in the coming months. For now, clinicians are reminded to follow the existing strict precautions, including:

  • that valproate should not be prescribed to female children or women of childbearing potential unless other treatments are ineffective or not tolerated
  • and that any use of valproate in women of childbearing potential who cannot be treated with other medicines is in accordance with the Pregnancy Prevention Programme

This issue contains the latest COVID-19 vaccine and medicine information including information on the authorisation of the Pfizer/BioNTech vaccine for use in infants and children aged 6 months to 4 years.

Lastly in this issue is a summary of letters to healthcare professionals in November. These generally related to supply issues and recalls.

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

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CKS Updates - November 2022

During November 2022 Clinical Knowledge Summaries were published or updated in the following areas.

The Long-term effects of coronavirus (long COVID) topic is new. All of the topics have been reviewed and updated with minor structural and layout changes. The Back pain - low (without radiculopathy) topic has been updated in line with NICE guidance, and the use of benzodiazepines for the management of muscle spasm associated with acute non-specific low back pain is no longer recommended.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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Drug Safety Update - November 2022

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for November 2022 (PDF).

This issue invites clinicians to respond to a consultation that will influence how the MHRA communicate with healthcare professionals in the future.

This issue contains the latest COVID-19 vaccine and medicine information including information on newly licensed vaccines and updated product information.

Lastly in this issue is a summary of letters to healthcare professionals in October. These generally related to supply issues and recalls.

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

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Antiviral Medicines Authorised for Influenza Season 2022/23

The Chief Medical Officer has written to healthcare professionals via the Central Alerting System (PDF) to advise that antiviral medicines may now be prescribed at NHS expense due to rising levels in reporting of influenza-like illness.

Surveillance data indicates an increase in influenza cases in the community and as such GPs and other prescribers working in primary care may now prescribe antiviral medicines for the prophylaxis and treatment of influenza. NICE has issued guidance on the treatment and prevention of influenza with antiviral medication.

Clinicians should remember to endorse the prescription with 'SLS' to ensure that it can be dispensed in community pharmacies without undue delay.

Action: Clinicians should be aware of this letter and familiarise themselves with the current prescribing guidance.

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