Issue 5 - May 2017
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Welcome to the May edition of Tablets, a prescribing newsletter produced monthly by the Medicines Management team at Midlands and Lancashire CSU.


Safety Update

For more information on the updates listed below, please click here:
Valproate and developmental disorders:

New alert asking for patient review and further consideration of risk minimisation measures.

Patient Safety Alerts have now been issued asking all organisations to undertake systematic identification of women and girls taking Valproate.

Mucodyne® Paediatric Syrup 250 mg/5 ml  (carbocisteine oral liquid):

New double-strength presentation - check dose volume to ensure appropriate dose is given

Mucodyne Paediatric Syrup has been re-launched and has double the concentration of the active ingredient carbocisteine per millilitre compared with the previous formulation.

Evidence of harm from fentanyl-contaminated heroin

This alert advises of the availability of, and harms from, heroin that has been mixed with fentanyl or carfentanyl, both unusually potent synthetic opioids.

Drug Availability


Products in short supply and product discontinuations

The following links provide prescribers with up to date information on commonly prescribed products which are currently in short supply from the manufacturers.

Please find a full list of drug product availability provided by ScriptSwitch®
The full list of Alliance healthcare's out of stock medication can be found here.

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. 

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

April BNF/BNF-C eNewsletter  

This latest issue includes updated guidance on management of erectile dysfunction/Crohn's disease/ulcerative colitis and new guidance on management of early sepsis, as well as updated MHRA advice on hyoscine butylbromide injection. Lithium citrate [Li-liquid®] dose has been updated.
National Institute of Health and Care Excellence (NICE) New or Updated guidance for April 2017.
The Irritable bowel syndrome in adults clinical guideline covers diagnosing and managing irritable bowel syndrome (IBS) in people aged 18 and over. It has been updated in line with more recent guidance on recognition and referral for suspected cancer. 
The Alcohol-use disorders clinical guideline covers care for adults and young people with physical health problems that are completely or partly caused by an alcohol-use disorder. It has been updated after an evidence review regarding corticosteroid treatment for people with severe alcohol-related hepatitis. 
Clinical Knowledge Summaries Updates for April 2017
The following topics were all reviewed: 
The topics have undergone minor restructures. The most significant change is that the recommendations on primary care management and referral for dyspepsia, including the management of severe oesophagitis, have been updated in line with NICE clinical guidance and the lower age limit has been changed from 16 to 18 years.
RightBreathe is a web-based resource designed specifically to help with the selection, prescribing, and on-going use of inhalers. It covers each and every inhaler and spacer device licensed in the UK for treating asthma and COPD. It enables clinicians and patients to search and filter the options to suit individual circumstances and patients' needs. It also maps all of the available options against local (London), national, and international prescribing pathways. The website is available at RightBreathe is available as a free at-the-point-of-use and up-to-date resource for 1 year from its launch on 20th February 2017 and is supported by the NHS London Procurement Partnership. 

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

Copyright © 2017 Midlands & Lancashire Commissioning Support Unit, All rights reserved.

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