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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - May 2022

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

Liraglutide (Saxenda®) has been accepted for restricted use as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adult patients with an initial Body Mass Index (BMI) of:

  • ≥30kg/m2 (obese), or
  • ≥27kg/m² to <30kg/m2 (overweight) in the presence of at least one weight-related comorbidity such as dysglycaemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia or obstructive sleep apnoea

The restriction limits use to patients at high risk of type 2 diabetes or cardiovascular disease and notes that patients should be treated in a specialist weight management service.

Dapagliflozin (Forxiga®) has been accepted for restricted use in the treatment of chronic kidney disease. The restriction limits use to patients who meet all of the following criteria:

  • estimated glomerular filtration rate of ≥25 to ≤75 mL/min/1.73m2 at treatment initiation
  • receiving an angiotensin converting enzyme inhibitor or angiotensin receptor blocker (unless these are not tolerated or contraindicated)
  • urine albumin creatinine ratio of at least 23mg/mmol, or type 2 diabetes mellitus or both

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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