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Issue 2 - February, 2017
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Welcome to Tablets, a prescribing newsletter produced monthly by the Medicines Management team at Midlands and Lancashire CSU.

Contents

Formulary Update

Recommendations

BLACK ASCORBIC ACID
The Pan Mersey Area Prescribing Committee does not recommend concurrent prescribing of ASCORBIC ACID in patients taking iron for treatment of irondeficiency anaemia. 
Tell me more about ascorbic acid
 
BLACK LACTASE ENZYME drops 50,000 units/g (Colief®)  
The Pan-Mersey Area Prescribing Committee recommends that Lactase Enzyme Drops 50,000 units/g (Colief®) are not prescribed on the NHS. Patients are advised to purchase Colief® if they wish. 
Tell me more about lactase enzyme drops
 
RED APREMILAST film coated tablets (Otezla®▼) for treating moderate to severe plaque psoriasis  
The Pan Mersey Area Prescribing Committee recommends the prescribing of APREMILAST film coated tablets (Otezla®▼) in specialist settings only, for treating chronic plaque psoriasis in accordance with NICE TA419. 
Tell me more about apremilast
 
AMBER TICAGRELOR tablets (Brilique®)  
The Pan Mersey Area Prescribing Committee recommends the prescribing of TICAGRELOR tablets (Brilique®), following specialist initiation, for the management of acute coronary syndromes in adults in accordance with NICE TA236 and for preventing atherothrombotic events after myocardial infarction in accordance with NICE TA420. 
Tell me more about ticagralor
 
GREEN COLECALCIFEROL products, LICENSED ORAL  
The Pan Mersey Area Prescribing Committee recommends that, where the prescribing of oral COLECALCIFEROLTell me more
products is deemed appropriate, licensed medicines should be prescribed for both adults and children. 
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GREEN DAPAGLIFLOZIN film coated tablets (Forxiga®▼) as triple therapy
The Pan Mersey Area Prescribing Committee recommends the prescribing of DAPAGLIFLOZIN film coated tablets (Forxiga®▼) as triple therapy for the treatment of type 2 diabetes in accordance with NICE TA418. 
Tell me more about dapagliflozin
 
 
GREEN FENTANYL transdermal patch - brand choice
The Pan Mersey Area Prescribing Committee recommends fentanyl transdermal patch is prescribed in primary care as one of the following brands: Fencino®, Matrifen®, Mezolar®, Mylafent® or Opiodur®. 
Tell me more about fentanyl patches
 
 
GREEN IBUPROFEN and NAPROXEN (oral formulations)  
The Pan Mersey Area Prescribing Committee recommends the prescribing of IBUPROFEN (low dose) and NAPROXEN (low dose) as the non-steroidal anti-inflammatory drugs (NSAIDs) of choice, if an NSAID is appropriate.
Tell me more about ibuprofen and naproxen.


Guidelines
 
Asthma treatment guideline for GPs and practice nurses - Children <5 years old  
Issued: January 2017 | Review: January 2020 
Tell me more about treating asthma in children < 5 years old 
 
Asthma treatment guideline for GPs and practice nurses - Children 5 years old and over 
Issued: January 2017 | Review: January 2020 
Tell me more about treating asthma in children 5 years old and over 
 
Blood glucose and ketone meters and testing strips  
Issued: January 2017 | Review: May 2018 
Tell me more about blood glucose and ketone meters and strips 
 
DIABETES, Mersey adult guidelines  
Issued: January 2017 | Review: December 2020 
Tell me more about Mersey diabetes guidelines 
 
Overactive Bladder Syndrome (OAB), Guidelines for Pharmacological Management of Adults in Primary Care  
Issued: January 2017 | Review: January 2020 
Tell me more about overactive bladder syndrome 
 
Biological agents pathway for Psoriatic Arthritis and Peripheral Spondyloarthropathy  
Issued: January 2017 | Review: January 2020 
Tell me more about biological agents



Safety
 
Insulin Comparison and Identification Guide 
This insulin identification chart aims to reduce the risk of unintentional duplication of similar insulins. 
Tell me more about insulin comparison and identification.



Shared Care
 
DENOSUMAB in osteoporosis  
Issued: January 2017 | Review: May 2020 
Tell me more about denosumab

Safety Update

Access a copy of February's safety report for more information on all of the safety updates below:
  • SPC Updates:
    • Revised SPC: ZEPATIER® (elbasvir and grazoprevir) film coated tablets
    • Revised SPC: Sustanon® 250, 250mg/ml solution for injection (testosterone propionate, testosterone phenylpropionate, testosterone isocaproate, testosterone decanoate)
    • Revised SPC: APO-go® (apomorphine) products.
  • Newsletter articles:
    • Class 4 Caution in Use: Arava® 10mg film-coated tablets (Leflunomide)
    • Case Study for Shared Learning: Over-ordering of fentanyl patches via repeat prescriptions
    • Drug Alert Class 4, Bayer Plc, Mirena 20 mcg/24 Hours Intrauterine Delivery System. PL 00010/0547
    • Direct-acting antivirals to treat chronic hepatitis C: risk of interaction with vitamin K antagonists and changes in INR.
    • Apremilast (Otezla ▼): risk of suicidal thoughts and behaviour.

Drug Availability

Short Supply / Out of Stock


The following links provide prescribers with up to date information on commonly prescribed products which are currently in short supply from the manufacturers.
The information held on these lists is not exhaustive. Availability can vary geographically and also between wholesalers. Up-to-date information should be sought from manufacturers, local community pharmacies and suppliers.  
 

Price Changes

 
This summary document shows the top 10 price changes this month, the top 25 changes this quarter, and the top 100 this year. 
 
Tell me more about drug tariff price changes.

Prescribing News

NICE Guidance

 
The National Institute of Health and Care Excellence (NICE) have published new or updated guidance.
 
The HIV testing guideline covers how to increase the uptake of HIV testing in primary and secondary care, specialist sexual health services and the community. It describes how to plan and deliver services that are tailored to the local prevalence of HIV, promote awareness of HIV testing and increase opportunities to offer testing to people who may have undiagnosed HIV.
 
The End of life care for infants, children and young people with life-limiting conditions guideline covers the planning and management of end of life and palliative care for infants, children and young people (aged 0–17 years) with life-limiting conditions. It aims to involve children, young people and their families in decisions about their care, and improve the support that is available to them throughout their lives. 
 
The Ticagrelor for preventing atherothrombotic events after myocardial infarction technology appraisal recommends this treatment as an option for preventing atherothrombotic events in adults who had a myocardial infarction and who are at high risk of a further event. Treatment should be stopped when clinically indicated or at a maximum of 3 years. 
 
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice. 


Clinical Knowledge Summaries 
 
The following topics have all been reviewed and updated: 
The updated shingles topic has amended recommendations with respect to the choice of drugs for neuropathic pain and also added sections on prevalence, risk factors, and differential diagnosis. There were also minor changes to the prescribing information section on antiviral drugs. The remaining changes for the other topics were minor structural changes. 
 
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
Please note that the information in this newsletter is correct at the time of publication.
Clinicians should always refer to the most up to date information.


Contacts
Kieron Donlon: kieron.donlon1@nhs.net - 0151 296 7076
Feedback - MLCSU.tabletsnewsletter@nhs.net

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