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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - January 2022

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of January 2022. This month there is one guideline, two technology appraisals and one innovation briefing that impact upon primary care.

The Glaucoma: diagnosis and management guideline has been updated. It covers diagnosing and managing glaucoma in people aged 18 and over. It includes recommendations on testing and referral (case-finding) for chronic open-angle glaucoma and ocular hypertension and on effective diagnosis, treatment and reassessment to stop these conditions progressing. This update reviewed the evidence and recommendations on treatment for ocular hypertension and chronic open-angle glaucoma and organisation of care.

The Solriamfetol for treating excessive daytime sleepiness caused by narcolepsy technology appraisal has been published. This treatment is recommended as an option for treating excessive daytime sleepiness in adults with narcolepsy with or without cataplexy. This recommendation applies only after modafinil and either dexamfetamine or methylphenidate have not worked well enough or are not suitable. It is expected that this medication would normally be requested by a specialist.

The Sodium zirconium cyclosilicate for treating hyperkalaemia technology appraisal has been updated. This treatment is recommended as an option for treating hyperkalaemia in adults under specific criteria. This update takes account that this treatment in now available in both primary and secondary care.

The Smart Peak Flow for monitoring asthma innovation briefing has been published. The briefing notes that Smart Peak Flow could replace mechanical peak flow meters. But evidence is needed on its validation against the current gold standard in peak flow meters, asthma-related outcomes, use and adherence, and the effect on clinical decision making and resource use. These briefings are usually used to guide local commissioning decisions and therefore clinicians should confirm local arrangements for this device.

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

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Drug Safety Update - January 2022

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

This issue contains the latest COVID-19 vaccine and medicine information including information on the approval of Paxlovid® for the treatment of COVID-19 in adults who are at risk of developing severe illness. It is noted that this medication may interact with other medications. Before it is prescribed, the MHRA is therefore advising that patients’ current medications should be carefully reviewed. Further information is available in the Summary of Product Characteristics.

Lastly in this issue is a summary of letters to healthcare professionals in December. 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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SMC Update - January 2022

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

Opicapone (Ongentys®) has been accepted for use as adjunctive therapy to preparations of levodopa/DOPA decarboxylase inhibitors (DDCI) in adult patients with Parkinson’s disease and end-of-dose motor fluctuations who cannot be stabilised on those combinations. It is noted that opicapone provides an additional treatment choice in the therapeutic class of catechol-O-methyl transferase inhibitors.

Budesonide (Cortiment®) has been accepted for use in the induction of remission in patients with active microscopic colitis. It is noted that other oral budesonide formulations are available at lower cost.

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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