Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Ingenol mebutate recalled

The manufacturer of ingenol mebutate (Picato®) has recalled all unexpired stock from wholesalers and pharmacies while investigations are ongoing into the concerns of the possible risk of skin malignancy.

Healthcare professionals are advised to:

  • Stop supplying the above products immediately. Quarantine all remaining stock and return it to your supplier using your supplier’s approved process
  • Stop prescribing Picato and consider other treatment options as appropriate. For patients who have recently been prescribed Picato, advise patients to be vigilant for any skin lesions developing and to seek medical advice promptly should any occur

Action: Clinicians should be aware of this recall and investigation. Alternatives will need to be issued during the remainder of the investigation.

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SMC Update - January 2020

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

Abiraterone (Zytiga®) has been accepted for use in combination with prednisone or prednisolone for the treatment of newly diagnosed high risk metastatic hormone sensitive prostate cancer in adult men in combination with androgen deprivation therapy. This advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) arrangement delivering the cost-effectiveness results upon which the decision was based. As such it would normally be prescribed by a specialist.

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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Drug Safety Update - December 2019

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for December 2019 (PDF).

This month clinicians are advice that domperidone is no longer licensed for use in children younger than 12 years or those weighing less than 35 kg. Results from a placebo-controlled study in children younger than 12 years with acute gastroenteritis failed to demonstrate any difference in efficacy at relieving nausea and vomiting compared with placebo. It is recommended that alternative treatments to domperidone are used in children younger than 12 years of age who need relief of symptoms of nausea and vomiting.

The summary of letters to healthcare professionals this month includes further links to letters recalling ranitidine, Emerade® adrenaline auto-injectors and several other pharmacy level drug 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 - December 2019

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

Prasterone (Intrarosa®) has been rejected for use in the treatment of vulvar and vaginal atrophy in postmenopausal women having moderate to severe symptoms. The manufacturer did not make a submission to the SMC and as such it cannot be recommend.

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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Drug Safety Update - November 2019

The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for November 2019 (PDF).

Clinicians are advised of stronger precautions in people with weakened immunity and in those aged 60 years or older when using the yellow fever vaccine. Strict adherence to contraindications and precautions is essential. New and updated contraindications and strengthened precautions aim to protect those with a weakened immune systems (including for people aged 60 years or older) and standardised risk-benefit evaluation procedures are advised across UK yellow fever vaccination centres to ensure that people only receive the vaccine after a thorough risk assessment. It is recommended that only healthcare professionals specifically trained in benefit-risk evaluation of yellow fever vaccine should administer the vaccine, following their individualised assessment of a person's travel itinerary and suitability to receive the vaccine.

The summary of letters to healthcare professionals this month includes several links to letters recalling ranitidine containing products from pharmacies and also a letter confirming that permission has been given to supply and use Quadrivalent Influenza Vaccine (split virion, inactivated) in packs designed for export in order to meet demand.

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

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