Issue 3 - March, 2017
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Welcome to the March edition of Tablets, a prescribing newsletter produced monthly by the Medicines Management team of Midlands and Lancashire CSU.


Safety Update

Access a copy of March's safety report for more information on all of the safety updates below:

SPC Updates:
  • Revised SPC: Exviera (dasabuvir) 250 mg film-coated tablets
  • Revised SPC: Olysio (simeprevir) 150mg hard capsules
  • Revised SPC: Viekirax (12.5 mg ombitasvir / 75mg paritaprevir /50 mg ritonavir) film-coated tablets

Newsletter articles:
  • Precautionary recall of Ergometrine Injections
  • Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease
  • Precautionary recall of Viridal Duo Powder and Solvent for Injection

Medical Device Alerts
  • Oxylog 3000 And Oxylog 3000 Plus Ventilator - Risk Of Failure

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.

Product Discontinuations
Kwells (hyoscine hydrobromide)
Bayer is currently facing some technical issues relating to manufacturing of, hyoscine hydrobromide and is thus not able to supply further stock for at least 6 months.
The memo which can be accessed below advises on alternative treatment options in the interim, with a focus on the off-label use for hypersalivation.
Shortage of hyoscine hydrobromide (Kwells) 150 and 300 microgram tablets
Prempak C and Premique
Pfizer had discontinued the manufacture of both strengths of Prempak C and Premique 625mcg tablets. Existing patients should be identified and reviewed with a view to switching to an alternative form of hormone replacement therapy in line with local formulary recommendations.

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 Drug misuse prevention guideline covers targeted interventions to prevent misuse of drugs, including illegal drugs, 'legal highs' and prescription-only medicines. It aims to prevent or delay harmful use of drugs in children, young people and adults who are most likely to start using drugs or who are already experimenting or using drugs occasionally
The Osteoporosis: assessing the risk of fragility fracture clinical guideline has been updated and covers assessing the risk of fragility fracture in people aged 18 and over with osteoporosis. It aims to provide guidance on the selection and use of risk assessment tools in the care of adults at risk of fragility fractures in all NHS settings. The update corrects the reference to the WHO in relation to the FRAX tool. 
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.


Clinical Knowledge Summaries

During February 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The topics have undergone minor restructures. More significant changes include recommendations for urgent referral for suspected cancer in the breathlessness topic and amending several recommendations about repeating swabs for staphylococcal carriage, reducing period of treatment for recurrent boils and antiseptic choice in line with advice from Public Health England.

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.

Kieron Donlon: - 0151 296 7076
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