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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - July 2024

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for July 2024 (PDF).

This issue advises clinicians about reports of ocular surface toxicity and ocular chemical injury associated with use of Epimax Ointment and Epimax Paraffin-Free Ointment. It is recommended to avoid prescribing or advising these products for use on the face. Patients should be advised to wash their hands after using these products and avoid touching their eyes. It is noted that the irritation should resolve on discontinuation but symptoms should but treatment with topical lubricants, topical antibiotics or topical steroids may be required.

Lastly, this issue contains a summary of letters to healthcare professionals in June. 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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SMC Update - July 2024

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

Empagliflozin (Jardiance®) has been accepted for restricted use in adults for the treatment of chronic kidney disease. The restriction limits use to patients on individually optimised standard care (with ACEi or ARB) and, at the start of treatment, either:

  • an estimated glomerular filtration rate (eGFR) of 20 mL/min/1.73m2 up to 45 mL/min/1.73m2, or
  • an eGFR of 45 mL/min/1.73m2 up to 90 mL/min/1.73m2 and either:
    • A urine albumin-to-creatinine ratio (uACR) of 22.6 mg/mmol or more, or
    • Type 2 Diabetes Mellitus

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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CKS Updates - June 2024

During June 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 Atrial fibrillation topic now includes information about the further assessment of device-detected atrial fibrillation, including use of patient-initiated mobile or wearable devices. The management section has also been split to cover new presentations and routine reviews separately. The Autism in adults topic has amended terminology to be consistent with NICE guidance from 2021. The Crohn's disease topic includes recent epidemiology figures and more detail on the management of a flare-ups. The Opioid dependence topic has been restructured with a focus on the generalist management of opioid dependency in primary care and information on what to expect from specialist drug services is included.

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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