The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for June 2023 (PDF).
This issue reminds clinicians that systemic non-steroidal anti-inflammatory drugs (NSAIDs) are contraindicated in the last trimester of pregnancy (29 weeks and after). Recent data has indicated that NSAIDs from week 20 of pregnancy onwards may be associated with an increased risk of oligohydramnios (low levels of amniotic fluid surrounding the baby) and foetal renal dysfunction. It is recommenced that if systemic NSAID after week 20 of pregnancy is considered necessary it should be used at the lowest effective dose and for the shortest period possible with due consideration for additional neonatal monitoring if used for longer than several days. Discontinuation of use of any NSAID in the last trimester of pregnancy is still advised.
This issue also notifies readers of a safety campaign that coincides with World Allergy Week that aims to to raise awareness of anaphylaxis and provide advice on the use of adrenaline auto-injectors (AAIs). An infographic and video have been produced to promote the safe and effective use of AAIs.
Lastly in this issue is a summary of letters to healthcare professionals in May. These generally related to supply issues and recalls. A reminder about last months Emerade® recall is included with a template letter for patients.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of June 2023. This month is one guideline and one technology appraisal that impact upon primary care.
The Atopic eczema in under 12s: diagnosis and management guideline has been updated. It covers diagnosing and managing atopic eczema in children under 12. The update reviewed the evidence on emollient bath additives and updated the recommendations on emollients. References to emollient bath additives have been removed and it is now recommended to not offer such products.
The Dapagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction technology appraisal has been published. The treatment is recommended, within its marketing authorisation, as an option for treating symptomatic chronic heart failure with preserved or mildly reduced ejection fraction in adults.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
During May 2023 Clinical Knowledge Summaries were published or updated in the following areas.
The Abdominal aortic aneurysm screening topic is new. The other topics have been reviewed and updated with minor structural and layout changes. The Conduct disorders in children and young people topic has been updated with definitions aligned to the 11th revision of the World Health Organisation's International Classification of Diseases (ICD-11) and with additional recommendations regarding assessment in primary care. The Acne vulgaris topic has been updated reflect the current bacterial taxonomy and references to topical isotretinoin preparations has been removed as these are no longer available in the UK.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
