Description

Review of Lincolnshire lipid modification guidance in response to the new NICE clinical guideline.

Description

Treatment selection: Newly diagnosed Atrial Fibrillation patients (CHA2DS2-VASc score > 1) requiring oral anticoagulant stroke thromboprophylaxis.

Treatment selection: Existing patients diagnosed with AF (CHA2DS2-VASc score > 1) currently taking a vitamin K antagonist.

NICE Technology Appraisal 249: Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation (March 2012).

NICE Technology Appraisal 256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation (May 2012).

NICE Technology Appraisal 275: Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation (February 2013).

NICE Clinical Guideline 180: Atrial fibrillation: the management of atrial fibrillation (June 2014).

Guidance on switching: Dabigatran, rivaroxaban or apixaban to warfarin Licensed doses for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation.

Guidance on switching: Warfarin to dabigatran, rivaroxaban or apixaban.

NICE Diagnostic Guidance 14: Atrial fibrillation and heart valve disease: self-monitoring coagulation status using point of care coagulometers (CoaguChek XS system and INRatio 2 PT/INR monitor) (September 2014).

Description

New Drug Assessment: Sodium hyaluronate 0.1% and dexpanthenol 2% eye drops (Hylo-Care).

New Drug Assessment: Budesonide/ formoterol fumarate breath actuated dry powder inhaler 160microgram/4.5microgram and 320microgram/9microgram (DuoResp Spiromax).

Rapid Drug Assessment: Beclometasone/ formoterol dry powder inhaler 100microgram/ 6microgram (Fostair NEXThaler).

Rapid Drug Assessment: Canagliflozin/metformin 50mg/850mg and 50mg/1000mg tablets (Vokanamet).

Rapid Device Assessment: Freestyle Libre glucose monitoring system.

New Device Assessment: Otovent autoinflation device for glue ear.

NICE Technology Appraisal 317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndrome (July 2014).

European Medicines Agency: PRAC recommends strengthening the restrictions on the use of valproate in women and girls.

Medicines and Healthcare products Regulatory Agency: Drug Safety Update (October 2014): Interferon-beta: Risk of thrombotic microangiopathy and risk of nephrotic syndrome; Dexamethasone 4mg/ml injection (Organon Laboratories Ltd): Reformulation with changes in name, concentration, storage conditions and presentation; Drugs and driving.

Description

Review: Needles for Pre-Filled and Reusable Pen Injectors.

Product Recall: Aciclovir 3% eye ointment (Zovirax).

New Drug Assessment: Calcium acetate capsules (PhosLo).

New Drug Assessment: Tocilizumab subcutaneous injection (RoActemra) for rheumatoid arthritis.

Rapid Drug Assessment: Polyethylene glycol 0.6% eye drops (Systane Balance).

New Device Assessment: Levonorgestrel 13.5mg intrauterine delivery system (Jaydess).

Specialised Services Circular: Primary care responsibilities in relation to the prescribing and monitoring of hormone therapy for patients undergoing or having undergone gender dysphoria treatments (March 2014).

NICE Technology Appraisal 320: Dimethyl fumarate for treating relapsing-remitting multiple sclerosis (August 2014).

Rapid Cost Comparison: Lower cost galantamine formulations.

Description

New Trial Assessment: Does daily aspirin reduce cancer risk?

New Drug Assessment: Alprostadil 300microgram in 100mg cream (Vitaros).

New Formulation Assessment: Methotrexate pre-filled pen for subcutaneous injection (Metoject).

Formulary Update: Finasteride 5mg tablets; Prochlorperazine 5mg in 5ml liquid (generic); Discontinuation of Ortho-Gynest (estriol) pessaries; Ibuprofen 10% gel (Fenbid).

NICE Technology Appraisal 316: Enzalutamide for metastatic hormone-relapsed prostate cancer previously treated with a docetaxel-containing regimen (July 2014).

NICE Technology Appraisal 319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma (July 2014).

Medicines and Healthcare Products Regulatory Agency, Drug Safety Update (August 2014): Levonorgestrel and ulipristal remain suitable emergency contraceptives for all women, regardless of body weight or body mass index.

Shared care update: Denosumab injection (Prolia) for Peterborough patients.

Medicines and Healthcare Products Regulatory Agency, Drug Safety Update (September 2014): Denosumab – Minimising the risk of osteonecrosis of the jaw; Nitrofurantoin now contraindicated in most patients with an estimated Glomerular Filtration Rate of less than 45ml/min; Domperidone – Risk of cardiac side effects – No longer available without prescription.

Description

Rapid Drug Assessment: Ropinirole 2mg, 4mg, 8mg sustained release tablets (Repinex XL).

Rapid Drug Assessment: Lecicarbon A suppositories.

Rapid Drug Assessment: Fluoxetine dispersible tablets 20mg (Olena).

NICE Technology Appraisal 308: Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody associated vasculitis (March 2014).

NICE Technology Appraisal 309: Pemetrexed maintenance treatment following induction therapy with pemetrexed and cisplatin for non-squamous non-small-cell lung cancer (April 2014).

NICE Technology Appraisal 310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer (April 2014).

NICE Technology Appraisal 311: Bortezomib for induction therapy in multiple myeloma before high dose chemotherapy and autologous stem cell transplantation (April 2014).

NICE Technology Appraisal 313: Ustekinumab for the treatment of psoriatic arthritis (May 2014).

Medicines and Healthcare Products Regulatory Agency: Drug Safety Update (June 2014): Combination use of medicines from different classes of renin-angiotensin system blocking agents; Ivabradine – emerging evidence of increased cardiovascular risk.

European Medicines Agency, Levonorgestrel and ulipristal remain suitable emergency contraceptives for all women, regardless of bodyweight (July 2014).

Medicines and Healthcare Products Regulatory Agency: Drug Safety Update (July 2014): Drugs and driving – Blood concentration limits to be set for certain controlled drugs in new legal offence; Transdermal fentanyl patches – Reminder of potential life-threatening harm from accidental exposure particularly in children.

Description

Review: Oxycodone preparations.

Rapid Drug Assessment: Buprenorphine patches (BuTrans and Transtec).

Product Discontinued: Fusidic acid 1% gel eye drops (Fucithalmic).

Rapid Cost Comparison: Ondansetron 4mg and 8mg oral film (Setofilm).

Description

Generic sildenafil tablets removed from the selected list scheme.

NICE Technology Appraisal 315: Canagliflozin in combination therapy for treating type 2 diabetes (June 2014).

Review of Prescribable Medical Devices: Silk garments for eczema/atopic dermatitis.

Rapid Drug Assessment: Fexofenadine 120mg and 180mg tablets.

Rapid Drug Assessment: Dapagliflozin/metformin 5mg/850mg and 5mg/1000mg tablets (Xigduo).

Description

New Drug Assessment: Brimonidine tartrate 3mg/g gel (Mirvaso) for facial erythema of rosacea.

Rapid Drug Assessment: Sodium chloride 5% preservative free eye drops (PF Drops and NaCl 5%).

Review: Melatonin prolonged-release 2mg tablets (Circadin).

Medicines and Healthcare products Regulatory Agency, Drug Safety Update (May 2014): Voriconazole – Reminder of risk of liver toxicity, phototoxicity and squamous cell carcinoma; Adrenaline Auto-injector – Advice for patients; Statins – Benefits and risks.

Description

Drug Safety Advice: Domperidone - risk of cardiac side effects.

Rapid Drug Re-Assessment: Sildenafil chewable tablets 25mg, 50mg and 100mg (Nipatra).

Rapid Drug Assessment: Avanafil 50mg, 100mg and 200mg tablets (Spedra).

Rapid Review: Resource ThickenUp Clear.

Rapid Re-Assessment: Omnitest 3 meter and blood glucose testing strips.

Review of expiry dates of blood glucose testing strips.

NICE Technology Appraisal 304: Total hip replacement and resurfacing arthroplasty for end-stage arthritis of the hip (February 2014).

NICE Technology Appraisal 305: Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion (February 2014).

NICE Technology Appraisal 306: Pixantrone monotherapy for treating multiply relapsed or refractory aggressive non-Hodgkin’s B-cell lymphoma (February 2014).

Medicines and Healthcare products Regulatory Agency, Drug Safety Update (April 2014): Tumour Necrosis Factor Alpha Inhibitors: Risk of tuberculosis.

NICE Technology Appraisal 307 Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy (March 2014).

Description

Changes to controlled drug legal classifications: tramadol, lisdexamfetamine, zopiclone and zaleplon.

New Device Assessment: Vibro-Pulse and Vibro-Pulse cycloidal vibration accessories.

New Drug Assessment: Fluticasone furoate/vilanterol inhalation powder (Relvar Ellipta).

Rapid Cost Comparison: Prescribe low cost generic triptans preferentially for migraine.

Rapid Wound Management Product Review: Coban 2 and Coban 2 Lite multi-layer compression bandage kit.

Prescribe nystatin oral suspension as Nystan.

Description

New Drug Assessment: Alogliptin 6.25mg, 12.5mg and 25mg tablets (Vipidia) and alogliptin/metformin 12.5mg/1g tablets (Vipdomet).

New Drug Assessment: Tamsulosin 400 microgram/ solifenacin 6mg modified release tablet (Vesomni).

Rapid Drug Assessment: Captopril oral solution 5mg in 5ml and 25mg in 5ml (Noyada).

Rapid Drug Assessment: Metolazone tablets 5mg and 10mg (unlicensed).

New Indication Assessment: Colesevelam 625mg capsules.

(Cholestagel) for the treatment of bile acid malabsorption.

Formulary Amendment: Sevelamer hydrochloride 800mg tablets (Renagel) to be removed from the Formulary.

Medicines and Healthcare Regulatory Agency: Drug Safety Update (March 2014) – Orlistat: theoretical interaction with antiretroviral medicines; St John’s wort: interaction with hormonal contraceptives; Strontium ranelate: cardiovascular risk; Methysergide serious fibrotic reactions; Dorzolamide hydrochloride/timolol maleate (Cosopt) preservative free eye drops: new pipette design; Combined hormonal contraceptives: risk of venous thromboembolism – clarification of advice.

Description

Rapid Cost Comparison: New lower cost oral contraceptives.

Rapid Cost Comparison: Levonorgestrel 1.5mg tablet (Upostelle).

Lincolnshire Audit of Waste Medicines: summary of results.

Supply Difficulties: Naftidrofuryl 100mg capsules – cilostazol 50mg and 100mg tablets are the preferred alternative.

Product Withdrawal: Metformin oral powder 500mg and 1g (Glucophage).

Description

Prescribing Advice - Guidance on the prescribing of Oral Nutritional Supplements (ONS).

Description

Increased risk of tuberculosis with anti-TNF alpha treatments.

New Drug Assessment: Nalmefene tablets 18mg (Selincro).

Alcohol Use Disorders Identification Test (AUDIT): Interview Questions.

Rapid Drug Assessment: Inactivated quadrivalent influenza vaccine (Fluarix Tetra).

Rapid Assessment: Accu-Chek Active blood glucose testing meter and strips.

Rapid Drug Assessment: Granisetron transdermal patch 3.1mg in 24 hours (Sancuso).

Monitoring patients prescribed lithium.

Policy Relating to the Prescribing, Supply, Storage and Disposal of Controlled Drugs in Primary Care (March 2014).

MHRA: Drug Safety Update (February 2014): Combined hormonal contraceptives and venous thromboembolism.

Description

Goodbye to minocycline?

New Formulation Assessment: Aripiprazole prolonged-release suspension for injection (Abilify Maintena).

Update on revised commissioning arrangements for depot antipsychotic drugs.

New Trial Assessments: Gout increasing but urate lowering therapies still under-used; Oral direct thrombin inhibitors and the risk of myocardial infarction.

Medicines and Healthcare Products Regulatory Agency: Drug Safety Update (January 2014): Prasugrel (Efient) – Increased risk of bleeding – information on timing of loading dose; Ofatumumab – screen for hepatitis B virus before treatment; Temozolomide – Risk of hepatic injury, including fatal hepatic failure – updated warnings and monitoring guidance; Capecitabine – Risk of severe skin reactions – discontinue treatment.

Description

Antiepileptic drugs – new advice on switching between different manufacturers’ products for a particular drug.

New Drug Assessment: Imiquimod 5% cream (Aldara).

Rapid Cost Comparison: Oxycodone standard release capsules (OxyNorm vs Lynlor vs Shortec).

Management of constipation.

New Drug Assessment: Lubiprostone 24 microgram capsules (Amitiza).

Description

New Drug Assessment: Meningococcal group B vaccine (Bexzero).

Rapid Drug Assessment: Bimatoprost/timolol 300microgram/5mg per ml unit dose eye drops (Ganfort UD).

Rapid Drug Assessment: Colecalciferol 20,000 IU tablets (SunVit D3).

Lincolnshire Joint Formulary Update – Venlafaxine modified release; Fentanyl patches; Ibandronate 150mg tablets.

New Trial Assessment: Anastrozole for the prevention of breast cancer in high-risk post-menopausal women.

Medicines and Healthcare Products Regulatory Agency: Drug Safety Update (November 2013): Mefloquine – strengthened warnings on neuropsychiatric side effects; Sodium valproate – risk of neurodevelopment delay in children following maternal use; Risperidone and paliperidone – risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery.

NICE Technology Appraisal 302: Canakinumab for treating systemic juvenile idiopathic arthritis (November 2013).

NICE Technology Appraisal 301: Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema after an inadequate response to prior therapy (November 2013).

Medicines and Healthcare Products Regulatory Agency: Drug Safety Update (December 2013): Rituximab – screen for hepatitis B virus before treatment; Clopidogrel – risk of acquired haemophilia; Dorzolamide hydrochloride/timolol (Cosopt) preservative free single dose eye drops – reports of eye injury.

Description

Prescribing lower cost blood glucose testing meters and strips.

Description

New Drug Assessment: Dapoxetine 30mg and 60mg tablets (Priligy).

New Formulation Assessment: Nicotine 2.5mg orodispersible film (NiQuitin Strips).

Rapid Drug Assessments: Timolol 0.1% single dose preservative free eye gel (Tiopex) and timolol 0.25% and 0.5% ophthalmic gel forming solution (Timoptol LA).

Ordering and claiming for varicella zoster virus vaccine (Zostavax).

Immediate release twice daily quetiapine tablets now preferred to modified release formulations.

Postscript: Aripiprazole (Abilify) for the treatment of schizophrenia and the treatment and prevention of mania.

NICE Technology Appraisal 299: Bosutinib for previously treated chronic myeloid leukaemia (November 2013).

NICE Technology Appraisal 300: Peginterferon alfa and ribavirin for treating chronic hepatitis C in children and young people (November 2013).

NICE Technology Appraisal 298: Ranibizumab for treating choroidal neovascularisation associated with pathological myopia (November 2013.)