Tablet Press Issue 100 The prescribing newsletter for GPs, nurses and pharmacists NHS Nene CCG and NHS Corby CCG January 2015 • NOAC alert cards Prescribers are reminded to please ensure that all patients started on a NOAC are fully counselled and provided with the patient information booklet and the alert card. It would be useful if community pharmacists can also check this at the time of dispensing. http://nww.pathfinder-rf.northants.nhs.uk/media/2961120/noac-patient-counselling-information.pdf • Reninder regarding PPD ‘flu vaccine claims Practices are reminded that where Fluenz Tetra vaccine nasal suspension or Influenza vaccine (live attenuated) nasal suspension have been centrally procured for the practice through Public Health England, they should not make a claim under personal administration arrangements to the NHSBSA on form FP34P/D. • Risk of misuse of gabapentin and pregabalin NHS England has issued advice for prescribers on the risk of the misuse of pregabalin and gabapentin. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/385791/PHENHS_England_pregabalin_and_gabapentin_advice_Dec_2014.pdf Prescribing of gabapentin and pregabalin in Northamptonshire has increased by 45% and 42% respectively from 2011/12 to 2013/2014. Whilst this is lower than the national trend of 46% (G) and 53% (P) it is still significant and there is a further projected increase of 12% and 19% for this year. • Emergency Hormonal Contraception There is no robust evidence to support ulipristal (Ellaone) being preferable to levonorgestrel (Levonelle) if the patient is “mid-cycle” or later - see p4-5 of the current FSRH guidelines http://www.fsrh.org/pdfs/CEUguidanceEmergencyContraception11.pdf Due to the significant cost differential between the two products the current recommendation in Northamptonshire remains that levonorgestrel should be used up to 72 hours post unprotected sexual intercourse and ulipristal from 72120 hours. • Prior Approval Pathfinder links Prescribers wishing to submit prior approval requests are reminded to check the prior approval criteria on Pathfinder to ensure that these are met in their application. http://nww.pathfinder-rf.northants.nhs.uk/nene/therapeutics/prior-approval/ • Prescribing to pregnant women UKMI have produced a useful Q&A document on prescribing in pregnancy. What should you think about when prescribing to pregnant women? • Vitamin K for reversal of over-anticoagulation GP practices in the North of the county are reminded that they are advised to hold stocks of vitamin K to reverse overanticoagulation in patients taking warfarin, on the advice of the anticoagulant nurse specialist at KGH. Full information is provided at http://nww.pathfinder-rf.northants.nhs.uk/media/3087910/vitamin-k-in-high-inr-nov-2011-1-.pdf • Stock problems with GSK dermatology products As you will be aware many of GSK’s dermatology products are out-of-stock and may be for some time http://hcp.gsk.co.uk/content/dam/Health/en_GB/DAM%20Content/Documents/Supply/dermatology.pdf Prescribers have asked us to try to clarify the stock problems and what alternatives might be used. Generic versions are available for all the out-of-stock GSK products except Eumovate cream (when hydrocortisone would be a suitable alternative) and Betnovate RD ointment. • Pioglitazone bladder cancer risk The evidence on the association between pioglitazone use and bladder cancer is contradictory, with many studies subject to allocation bias. In a large, pooled multi-population analysis the cumulative use of pioglitazone or rosiglitazone was not associated with the incidence of bladder cancer. http://link.springer.com/article/10.1007/s00125-014-3456-9 This edition is also available on PathfinderRF via the following link http://nww.pathfinder-rf.northants.nhs.uk/nene and on the Nene CCG and Corby CCG websites Disclaimer Information in this newsletter is believed to be accurate and true. NHS Nene CCG and NHS Corby CCG and their employees accept no liability for loss of any nature, to persons, organisations or institutions that may arise as a result of any errors or omissions. 01604 651359
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