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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - April 2022

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of April 2022. This month there are two guidelines that impact upon primary care.

The Epilepsies in children, young people and adults guideline has been published. It covers diagnosing and managing epilepsy in children, young people and adults in primary and secondary care, and referral to tertiary services. It aims to improve diagnosis and treatment for different seizure types and epilepsy syndromes, and reduce the risks for people with epilepsy.

The Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults guideline has been published. It covers general principles for prescribing and managing withdrawal from opioids, benzodiazepines, gabapentinoids, Z‑drugs and antidepressants in primary and secondary care.

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 - April 2022

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

This issue advises that a recent study has indicated that pregabalin may slightly increase the risk of major congenital malformations if used in pregnancy. Data from 2,700 pregnancies with pregabalin exposure in the first trimester was compared with exposure to no antiepileptic drugs or lamotrigine or duloxetine. Full details of the study have been published. Patients are advised to continue to use effective contraception during treatment and avoid use in pregnancy unless clearly necessary.

This issue contains the latest COVID-19 vaccine and medicine information including reassuring real-world data for for Spikevax COVID-19 vaccine and Comirnaty COVID-19 vaccine when used during pregnancy and breastfeeding. This section also notifies readers of the approval of Valneva COVID-19 vaccine and Evusheld (tixagevimab/cilgavimab) for COVID-19 prevention.

Lastly in this issue is a summary of letters to healthcare professionals in March. 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 - March 2022

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

The Rehabilitation after traumatic injury topic is new. The remaining topics have been reviewed and updated in keeping with current guidance with minor layout changes. The Breastfeeding problems topic contains updates to the section on management of suspected ductal infection to reflect a lack of evidence of the role of bacteria and yeast and to support the judicious use of antimicrobials. The Cervical cancer and HPV topic has been updated in line with current evidence in the literature and a new section on Assessment has been added to the Diagnosis section. The Molluscum contagiosum topic contains a new section on Risk factors in Background information.

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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