Issue 1 - January 2017

Welcome to the brand new format for Tablets, a prescribing newsletter produced monthly by the Medicines Management team at Midlands and Lancashire CSU.


Formulary Update


RED CERTOLIZUMAB injection (Cimzia®) in rheumatological conditions
The Pan Mersey Area Prescribing Committee recommends the prescribing of certolizumab injection (Cimzia®) for rheumatoid arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis and psoriatic arthritis, as well as in patients fitting other criteria commissioned by Pan Mersey CCGs.
Tell me more about certolizumab in rheumatological conditions.

RED CERTOLIZUMAB PEGOL injection (Cimzia®) in rheumatoid arthritis
The Pan Mersey Area Prescribing Committee recommends the prescribing of certolizumab pegol injection (Cimzia®) in rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor, in accordance with NICE TA 415.
Tell me more about certolizumab in rheumatoid arthritis.

RED SODIUM OXYBATE oral solution (Xyrem®)
The Pan Mersey Area Prescribing Committee recommends Sodium Oxybate Oral Solution (Xyrem®) as a treatment option for narcolepsy with cataplexy in adult patients only when recommended by a consultant in a specialist commissioned sleep service.
Tell me more about sodium

GREY USTEKINUMAB injection (Stelara®) for Crohn’s disease
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of USTEKINUMAB injection (Stelara®) for the treatment of Crohn’s disease.
Tell me more about ustekinumab.


Overactive bladder in children over 5 years old, prescribing algorithm
Issued: November 2016 | Review: November 2018
Tell me more about overactive bladder in children.

Shared Care

ATOMOXETINE shared care framework
Issued: November 2016 | Review: November 2019
Tell me more about atomoxetine.

DEXAMFETAMINE shared care framework
Issued: November 2016 | Review: November 2019
Tell me more about dexamfetamine.

GUANFACINE shared care framework
Issued: November 2016 | Review: November 2019
Tell me more about guanfacine.

LISDEXAMFETAMINE shared care framework
Issued: November 2016 | Review: November 2019
Tell me more about lisdexamfetamine.

METHYLPHENIDATE shared care framework
Issued: November 2016 | Review: November 2019
Tell me more about methylphenidate.

Safety Update

For more information on the updates listed below, please click here:
  • SPC Updates
  • Safety Articles:
    • Brimonidine gel (Mirvaso®): risk of exacerbation of rosacea
    • Report suspected side effects - MHRA launches social media campaign
    • BNF November/December 2016 updates
    • Patient Safety Alert: Risk of severe harm and death due to withdrawing insulin from pen devices
    • Drug Alert Class 4 Caution In Use; Medreich; Amoxicillin Sugar-Free Suspension 250mg/5l And 125mg/5l; Pl 21880/0124 And Pl 21880/0123
    • Spironolactone and renin-angiotensin system drugs in heart failure: risk of potentially fatal hyperkalaemia
    • Central Alerting System: Influenza Season 2016/17: Use of Antiviral Medicines
    • Cobicistat, ritonavir and co-administration with a steroid: risk of systemic corticosteroid adverse effects
  • Case Studies
    • Alert: Glass shards found in balloon gastrostomy tube balloon ports.

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 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. 
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 price changes.

Prescribing News

British Asthma Guideline Update
The British Asthma Guideline jointly published by the British Thoracic Society and the Scottish Intercollegiate Guidelines Network has been updated. Available in a Quick Reference format or as a Full Guideline, the guideline covers diagnosis and management of asthma in adults and children. This update contains minor corrections and changes (apart from change advised to now immediately treat children under 2 years old in hospital settings with acute asthma symptoms).
Action: This guideline is a cornerstone of asthma management. Clinicians who diagnose and treat asthma should be aware of this update and have access to this guideline.

NICE Guidance - November 2016
NICE have published new or updated guidance for the month of November 2016. There are two guidelines and three technology appraisals that impact upon primary care and the full update can be accessed here.
The Hypertension in adults guideline covers identifying and treating primary hypertension in people aged 18 and over. It has been updated to include two MHRA drug safety alerts regarding ACE inhibitor use during pregnancy and breastfeeding.
The Diabetes in children and young people guideline covers the diagnosis and management of type 1 and type 2 diabetes, in children and young people aged under 18. It has been updated to add information on when eye screening should begin and referral for eye screening should happen.

Electronic Repeat Dispensing (
eRD) Awareness Campaign
NHS Digital has developed a series of materials to boost the usage of electronic repeat dispensing (
eRD) as part of a newly launched awareness campaign. The campaign will run from Nov 2016 to March 2017. As part of the campaign to combat the low uptake of eRD, a strategy has been developed to convert up to 80% of repeat prescriptions to electronic repeat dispensing prescriptions. NHS Digital have developed a suite of online support tools summarising activities, toolkits, learning resources and support material that can be accessed by clicking here.

CKS Updates - November 2016
During November 2016, two new Clinical Knowledge Summaries were added for the following:
Pharmacy Quality Payments
As part of the moves to restructure payments under the community pharmacy contract, NHSE is launching a Quality Payment Scheme. This will make £75m available to pharmacies which satisfy a range of criteria. This is the first step towards linking remuneration to quality factors, rather than dispensing volume. Quality encompasses the following dimensions: clinical effectiveness, patient safety and patient experience. For a pharmacy to become eligible for any payment under the Quality Payments Scheme it must first meet four gateway criteria. The payment will then depend on how many of the quality criteria the pharmacy achieves, these include:
  • a requirement to record and learn from incidents and share learning
  • a requirement for pharmacy staff to have undergone safeguarding training
  • patients who have collected over 6 short-acting reliever inhalers without a corticosteroid inhaler in the previous 6 months to be referred to an appropriate healthcare professional.
  • Evidence of increasing use of the summary care record.
Click here for more information.
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
Feedback -

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

unsubscribe from this list | update your preferences
Email Marketing Powered by Mailchimp