Copy
Issue 9 - October 2017
Email not displaying correctly? View it in your browser.

Welcome to the October edition of Tablets, a prescribing newsletter produced monthly by the Medicines Management team at Midlands and Lancashire Commissioning Support Unit.
 

Contents

Formulary Update

Recommendations
 
NALMEFENE film coated tablets (Selincro®▼)
Refer to Mersey Formulary for RAG status for each individual CCG
The Pan Mersey Area Prescribing Committee recommends the prescribing of NALMEFENE (Selincro®▼) within its marketing authorisation, as an option for reducing alcohol consumption in adults with alcohol dependence, in line with NICE TA325.
Tell me more about Nalmefene


GREY FreeStyle Libre
®
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of flash blood glucose monitor (FreeStyle Libre®) for blood glucose monitoring.
Tell me more about FreeStyle Libre


GREY LEVONORGESTREL19.5 mg intrauterine delivery system (Kyleena
®)     
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of the levonorgestrel 19.5 mg intrauterine delivery system (Kyleena®) for contraception.
Tell me more about Kyleena


RED BARICITINIB film-coated tablets (Olumiant
®)     
The Pan Mersey Area Prescribing Committee recommends the prescribing of BARICITINIB film-coated tablets (Olumiant
®), by specialists only, for rheumatoid arthritis in accordance with NICE TA466.
Tell me more about Baricitinib


RED INTRAVENOUS BISPHOSPHONATES for treating osteoporosis  
The Pan Mersey Area Prescribing Committee recommends the prescribing of INTRAVENOUS BISPHOSPHONATES (ibandronic acid and zoledronic acid), by specialists only, for treating osteoporosis in accordance with NICE TA464.
Tell me more about intravenous bisphosphonates


RED COLLAGENASE CLOSTRIDIUM HISTOLYTICUM injection (Xiapex
®) for Dupuytren's contracture  
The Pan Mersey Area Prescribing Committee recommends the prescribing of COLLAGENASE CLOSTRIDIUM HISTOLYTICUM injection (Xiapex
®), by hand surgeons only, for the treatment of Dupuytren's contracture with a palpable cord in adults in accordance with NICE TA459.
Tell me more about Xiapex


RED DEXAMETHASONE intravitreal implant (Ozurdex
®)
The Pan Mersey Area Prescribing Committee recommends the prescribing of DEXAMETHASONE intravitreal implant (Ozurdex
®), by ophthalmologists only, for treating non-infectious uveitis in accordance with NICE TA460. http://www.panmerseyapc.nhs.uk/recommendations/documents/PS44.pdf

RED DIMETHYL FUMARATE tablets (Skilarence
®)
The Pan Mersey Area Prescribing Committee recommends the prescribing of DIMETHYL FUMARATE Tablets (Skilarence
®), by specialists only, for severe plaque psoriasis in accordance with NICE TA475
Tell me more about Dimethyl fumarate


RED RANIBIZUMAB intravitreal injection (Lucentis
®)for choroidal neovascularisation  
The Pan Mersey Area Prescribing Committee recommends the prescribing of RANIBIZUMAB intravitreal injection (Lucentis
®), by ophthalmologists only, for the treatment of visual impairment secondary to choroidal neovascularisation (CNV) in conditions not covered by NICE technology appraisals.
Tell me more about Ranibizumab


AMBER AZITHROMYCIN oral liquid and tablets - paediatric use 
The Pan Mersey Area Prescribing Committee recommends the prescribing of azithromycin following specialist initiation for certain chronic airway conditions in children.
Tell me more about Azithromycin


AMBER ELUXADOLINE tablets (Truberzi
®)
The Pan Mersey Area Prescribing Committee recommends the prescribing of ELUXADOLINE Tablets (Truberzi
®) following specialist initiation for irritable bowel syndrome with diarrhoea in adults in accordance with NICE TA471.
Tell me more about Eluxadoline


AMBER ROFLUMILAST tablets (Daxas
®)
The Pan Mersey Area Prescribing Committee recommends the prescribing of ROFLUMILAST tablets (Daxas
®) following specialist recommendation as an add-on to bronchodilator therapy, for treating severe chronic obstructive pulmonary disease in adults with chronic bronchitis (in accordance with NICE TA461)
Tell me more about Roflumilast


GREEN ORAL BISPHOSPHONATES  for treating osteoporosis 
The Pan Mersey Area Prescribing Committee recommends the prescribing of ORAL BISPHOSPHONATES (alendronic acid, ibandronic acid and risedronate sodium) for treating osteoporosis in accordance with NICE TA464.
Tell me more about oral bisphosphonates


Guidelines

Glyceryl Trinitrate Transdermal Patch For Children
Issued: September 2017 | Review: September 2020 Tell me more about GTN patches


Shared Care

Azathioprine
Issued: September 2017 | Review: September 2020
Tell me more about Azathioprine

Ciclosporin
Issued: September 2017 | Review: September 2020
Tell me more about Ciclosporin

Leflunomide
Issued: September 2017 | Review: September 2020
Tell me more about Leflunomide

Mercaptopurine
Issued: September 2017 | Review: September 2020
Tell me more about Mercaptopurine

Methotrexate
Issued: September 2017 | Review: September 2020
Tell me more about Methotrexate

Mycophenolate mofetil
Issued: September 2017 | Review: September 2020
Tell me more about Mycophenolate mofetil

Penicillamine
Issued: September 2017 | Review: September 2020
Tell me more about Penicillamine

Riluzole
Issued: September 2017 | Review: September 2020
Tell me more about Riluzole

Sodium aurothiomalate
Issued: September 2017 | Review: September 2020
Tell me more about Sodium aurothiomalate

Sulfasalazine
Issued: September 2017 | Review: September 2020
Tell me more about Sulfasalazine


Safety

Shingles vaccine contraindicated in immunosuppressed post-transplant patients
Zostavax is a live, attenuated varicella-zoster vaccine and administration may result in disseminated disease in individuals who are immunosuppressed or immunodeficient. Refer to the summary of product characteristics for a complete list of contraindications, special warnings and precautions for use.
http://www.medicines.org.uk/emc/medicine/25927

Safety Update

For more information on the updates listed below, please click here

Error with the barcodes on selected batches of 8 medicinal products 
Central Alerting System | 04 Sep 2017

 
All Accu-Chek® Insight insulin pumps – risk of alarm failure 
Central Alerting System | 21 Sep 2017

 
Loperamide (Imodium): reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse 
MHRA Drug Safety Update | 26 Sep 2017

Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin 
MHRA Drug Safety Update | 26 Sep 2017

Xarelto 20 mg film-coated tablets - CLASS 2 MEDICINES RECALL
 Central Alerting System | 28 Sep 2017

Guidance for the Correct Use and Disposal of Batteries Used in Health and Social Care Equipment 
Central Alerting System | 06 Sep 2017

 
What is the risk of interaction between opioids and monoamine oxidase inhibitors (MAOIs)? 
South West Medicines Information and Training | 27th September 2017

SPC updates here
 

Drug Availability

The following links provide prescribers with up to date information on commonly prescribed products which are currently out of stock from the manufacturers
 
Scriptswitch
Alliance Healthcare


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.

Products in short supply

Shortage of Vamju

There is currently a supply problem affecting all strengths of Vamju tablets (Gliclazide 30mg and 60mg modified release tablets). The manufacturers Concordia are unable to confirm a date when further stocks will be made available. Prescribers are advised to prescribe generically in the interim period.

Shortage of Adalat Retard 10mg

There is currently a supply problem affecting Adalat Retard 10mg tablets. The manufacturers Bayer are not expecting any further stock until the beginning of December 2017. Prescribers are advised to use alternative branded generic formulations including Adipine MR, Nifedipress MR or Tensipine MR.
NB prescribers are reminded that different versions of modified release preparations may not have the same clinical effect and patients may require additional monitoring when initially switching to an alternative preparation.

Drug tariff 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

Using emergency adrenaline auto-injectors in schools

From 1 October 2017, schools in England will be allowed to purchase adrenaline auto-injector (AAI) devices without a prescription, for emergency use on children who are at risk of anaphylaxis but whose own device is not available or not working. This DoH guidance will help schools that choose to keep an emergency AAI to create a policy for using it.


NICE Guidance - September 2017.

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance that impact upon primary care.

The Type 2 diabetes: prevention in people at high risk public health guideline has been updated following a review of the evidence for lifestyle-change programmes. Recommendations about lifestyle-change programmes were added and advice on when to offer metformin was changed.

The Depression in children and young people clinical guideline has been updated. Several footnotes have been clarified and recommendations for therapist training added.

The Sepsis guideline has been updated to clarify or correct several recommendations and also to revise the risk level of several symptoms associated with sepsis.

The Fertility problems clinical guideline has been updated. Section 1.7 has been replaced by recommendations in the guideline for endometriosis.

The Endometriosis guideline has been updated to include recommendations on fertility tests and treatments such as assisted reproduction.

The Psoriasis clinical guideline has been updated throughout to include links to other NICE guidance and other relevant resources.

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

 
Clinical Knowledge Summaries Updates for September 2017
 
The most significant changes are in the Diverticular disease topic where sections on risk factors and prognosis have been added and the recommendations on assessment and management of suspected acute diverticulitis have been amended in line with current evidence.
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