The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for May 2024 (PDF).
This issue advises clinicians that in the coming months topical steroids will start to be labelled with potency information to assist with counselling patients with the aim of reducing the risk of developing topical steroid withdrawal reactions. The risk of such reactions increases with prolonged use and increased steroid potency. It is also recommended that when prescribing or dispensing topical steroids, clinicians should advise on the amount of product to apply, how often, where to apply it and when to stop treatment. Fingertip Units can be a convenient way to advise and measure an appropriate amount of product to apply.
This issue also contains a summary of letters to healthcare professionals in April. These generally related to supply issues and recalls. One letter raises awareness of the discontinuation of Levemir and Insulatard Innolet devices and several needles in the range from the same manufacturer.
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 May 2024. This month there are two guidelines that impact upon primary care.
The COVID-19 rapid guideline: managing COVID-19 guideline has been updated. It covers managing COVID-19 in babies, children, young people and adults in community and hospital settings. The update includes revised guidance and new recommendations on the use of anti-vial treatments for COVID-19.
The Atogepant for preventing migraine guideline has been published. It recommends this treatment as an option for preventing migraine in adults who have at least 4 migraine days per month, only if at least 3 preventive medicines have failed. It is further advised that treatment is stopped after 12 weeks if the frequency of migraine does not reduce by 50% in the case of episodic migraine or 30% in the case of chronic migraine. This treatment is reviewed in comparison to monoclonal antibody treatments and botulinum toxin type A and as such recommendation and treatment initiation would be supervised by a specialist.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
During April 2024 Clinical Knowledge Summaries were published or updated in the following areas.
All of the topics have been reviewed and updated with minor structural and layout changes. The Axial spondyloarthritis topic has been renamed from "Ankylosing spondylitis" in line with current terminology, recommendations have been updated in line with current evidence and a new Assessment section has been added. The Hypercholesterolaemia - familial topic has a new section describing important risk factors and the prescribing information now includes bempedoic acid and inclisiran. The Insomnia topic now incorporates NICE recommendations on the use of Sleepio and daridorexant in the management of insomnia.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
The Department of Health and Social Care has announced changes to the NHS Prescription Charges that take effect from the 1st May 2024.
The prescription charge has increased by 25 pence from £9.65 to £9.90 for each item dispensed. In line with this increase, the price of the 3 month, 12 month and HRT Pre-Payment certificates has also increased, to £32.05, £114.50 and £19.80 respectively.
Action: Clinicians should be aware of the current prescription charge and also the value for money represented by pre-payment certificates, including the new HRT pre-payment certificate.
