Prescribing Advice for GPs

SMC Update - April 2025

April 8, 2025 at 8:28 am | In Prescribing Extra - Drugs | Print | No Comments

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

Dapagliflozin (Forxiga^®) has been accepted for restricted use in adults for the treatment of chronic kidney disease (CKD). The restriction limits use to patients having individually optimised standard care (including angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, unless these are contraindicated or not tolerated), and either, at the start of treatment:

• 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 (T2DM)

It is noted that dapagliflozin offers an additional treatment choice in the therapeutic class of sodium-glucose co-transporter 2 (SGLT2) inhibitor.

Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.