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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

SMC Update - September 2022

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

Estradiol / micronised progesterone (Bijuve®) has been accepted for use as continuous combined hormone replacement therapy (HRT) for oestrogen deficiency symptoms in postmenopausal women with intact uterus and with at least 12 months since last menses. It is noted that the experience in treating women older than 65 years is limited.

Apalutamide (Erleada®) has been accepted for restricted use in the treatment of adults with metastatic hormone-sensitive prostate cancer (mHSPC) in combination with androgen deprivation therapy (ADT). This advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) arrangement.

Delta-9-tetrahydrocannabinol and cannabidiol (Sativex®) has been accepted for use as a treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy. Based upon the need for an initial trial it is expected that treatment would normally be initiated by a specialist.

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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