Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Drug Safety Update - March 2017

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for March 2017 (PDF).

This issue contains updated advice on the increased risk of lower-limb amputation (mainly toes) associated with use of the SGLT2 inhibitor canagliflozin. The updated advice notes that the current evidence does not show an increased risk for dapagliflozin and empagliflozin, but warns the risk may be a class effect. As previously suggested, patients receiving canagliflozin should be monitored for risk factors for amputation such as poor diabetes control and vascular disease. Treatment should be stopped if foot complications such as infection, skin ulcers, osteomyelitis or gangrene develop. It is also noted that preventive foot care is important for all patients with diabetes and especially in those being treated with an SGLT2 inhibitor.

The issue also announces a year long pilot of a reporting scheme for healthcare professionals to report suspected adverse reactions to illicit drugs, particularly new psychoactive substances (or 'legal highs'). A new site is available containing the Report Illegal Drug Reaction form that also collects information about licensed medicine that may help identify common issues arising from combinations of specific licensed medicines and psychoactive substances.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'Drug Safety Update - March 2017' on Email Share 'Drug Safety Update - March 2017' on Delicious Share 'Drug Safety Update - March 2017' on Digg Share 'Drug Safety Update - March 2017' on Facebook Share 'Drug Safety Update - March 2017' on Google+ Share 'Drug Safety Update - March 2017' on reddit Share 'Drug Safety Update - March 2017' on StumbleUpon Share 'Drug Safety Update - March 2017' on Twitter

SMC Update - March 2017

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

Lacosamide (Vimpat®) has been rejected for use as monotherapy in the treatment of partial-onset seizures with or without secondary generalisation in adult and adolescent (16-18 years) patients with epilepsy. The manufacturer failed to make a submission.

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

Share 'SMC Update - March 2017' on Email Share 'SMC Update - March 2017' on Delicious Share 'SMC Update - March 2017' on Digg Share 'SMC Update - March 2017' on Facebook Share 'SMC Update - March 2017' on Google+ Share 'SMC Update - March 2017' on reddit Share 'SMC Update - March 2017' on StumbleUpon Share 'SMC Update - March 2017' on Twitter

Drug Safety Update - February 2017

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for February 2017 (PDF).

Healthcare professionals are advised that hyoscine butylbromide (Buscopan®) injection can cause serious adverse effects including tachycardia, hypotension and anaphylaxis that can result in a fatal outcome in patients with underlying cardiac disease, such as those with heart failure, coronary heart disease, cardiac arrhythmia or hypertension. It should be used with caution in such patients and is contraindicated in tachycardia.

Readers are also notified that Yellow Card reporting has been added to a second clinical software system. Integrated reporting is now available in Vision in addition to SystmOne. All suppliers of primary care systems must integrate electronic Yellow Card facilities into their clinical software in the future as required by the NHS GP Systems of Choice Programme.

There is also a summary of letters sent to healthcare professionals in January including notification of the end of supply shortages affecting Insuman®, an insertion tube defect affecting batch TU01BPE of Mirena® and a reminder about the Pregnancy Register for reporting pregnancies exposed to ellaOne®.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'Drug Safety Update - February 2017' on Email Share 'Drug Safety Update - February 2017' on Delicious Share 'Drug Safety Update - February 2017' on Digg Share 'Drug Safety Update - February 2017' on Facebook Share 'Drug Safety Update - February 2017' on Google+ Share 'Drug Safety Update - February 2017' on reddit Share 'Drug Safety Update - February 2017' on StumbleUpon Share 'Drug Safety Update - February 2017' on Twitter

SMC Update - February 2017

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

Desmopressin (Noqdirna®) has been rejected for use in the symptomatic treatment of nocturia due to idiopathic nocturnal polyuria in adults. The submitting company did not present sufficiently robust clinical and economic analyses to gain acceptance.

Evolocumab (Repatha®) has been accepted for restricted use in adults with primary hypercholesterolaemia (heterozygous familial hypercholesterolaemia and non-familial) or mixed dyslipidaemia, as an adjunct to diet, in combination to reach treatment goals or alone when other treatments are not tolerated. The restriction limits use to specialist use in patients at high cardiovascular risk.

Pitolisant (Wakix®) has been rejected for the treatment of narcolepsy with or without cataplexy in adults. The manufacturer failed to make a submission.

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

Share 'SMC Update - February 2017' on Email Share 'SMC Update - February 2017' on Delicious Share 'SMC Update - February 2017' on Digg Share 'SMC Update - February 2017' on Facebook Share 'SMC Update - February 2017' on Google+ Share 'SMC Update - February 2017' on reddit Share 'SMC Update - February 2017' on StumbleUpon Share 'SMC Update - February 2017' on Twitter

Drug Safety Update - January 2017

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for January 2017 (PDF).

Healthcare professionals are advised that INR should be monitored closely during treatment of chronic hepatitis C with direct-acting antivirals in patients also receiving vitamin K antagonists (e.g. warfarin), because of possible changes in liver function during treatment.

It is also noted that a review of the evidence from clinical trials and postmarketing cases has suggested a causal association between apremilast (Otezla®) and suicidal thoughts and suicidal behaviour. Any patient presenting with new or worsening depression and suicidal thoughts should have treatment stopped.

There is also a summary of letters sent to healthcare professionals in December including notification of the potential for medication errors associated with overdose with liquid levetiracetam, usually in children. To minimise the risk it is recommended that the dosing directions should specify the dose in milligrams and millilitres and patients should be advised to only use the medicines syringe supplied with the medicine.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'Drug Safety Update - January 2017' on Email Share 'Drug Safety Update - January 2017' on Delicious Share 'Drug Safety Update - January 2017' on Digg Share 'Drug Safety Update - January 2017' on Facebook Share 'Drug Safety Update - January 2017' on Google+ Share 'Drug Safety Update - January 2017' on reddit Share 'Drug Safety Update - January 2017' on StumbleUpon Share 'Drug Safety Update - January 2017' on Twitter

« Older Posts

Prescribing Advice for GPs is powered by WordPress.
Subscribe for Free to our RSS or Atom Feeds for New Entries.
Akismet has protected Prescribing Advice for GPs from 788,904 spam comments.

atomic-wealth
fond-illness
summer