BLACK Omeprazole oral liquid
Change of RAG designation. Previously green and amber recommended in children < 12 years of age. Now black and amber recommended in children < 2kg or < 1 year old with a narrow feeding tube and green in other patients with a feeding tube at risk of tube blockage. Significant potential cost savings are possible from the use of dispersible tablets instead of oral liquid where clinically appropriate.
RED Ankylosing spondylitis and non-radiographic axial spondyloarthritis - statement and pathway
Update of existing documents to include NICE TA's 718 and 719 for secukizumab and ixekizumab already approved by APC.
RED Adult-onset Stills disease - statement andpathway
Update of existing documents to include NICE TA685 for anakinra already approved by APC and link to NHSE commissioning policy stating that it commissions tocilizumab for adult-onset Still’s disease.
Headache pathway
Update of existing pathway. Detailed clinical updates, no change to drug choices or RAG designations.
GREEN Actimorph® (morphine sulphate orodispersible tablets) for severe pain
Formulary addition of morphine sulphate orodispersible tablets (Actimorph®) to the Pan Mersey Formulary as a second-line option after oral morphine oral solution. Cost impact is not thought to be significant.
Shared Care
AMBER RETAINED Hydroxychloroquine
Minor update to prescribing support information document to include recent RMOC guidance as a reference, for completeness.
Safety Update
Please click herefor a full summary of safety updates and SPC updates in September.
Regulation 28 report to prevent future deaths Concerns include systematic review for all patients receiving repeat prescriptions of multiple analgesics to formulate individual plans.
Safety considerations when using Vitamin D The number of available products has resulted in variability of clinical guidance in recommended reference sources and clinical use. Healthcare professionals who should be aware of the risks of toxicity and safe practice principles which may prevent patient harm.
The Obesity: identification, assessment and management guideline has been updated. The guideline has been updated following a review on the evidence on anthropometric measures for assessing health and risks associated with overweight and obesity in adults and updated the recommendations on identifying and assessing overweight, obesity and central adiposity.
The Self-harm: assessment, management and preventing recurrence guideline has beenpublished. The guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
Clinicians should be aware of this guideline and implement any necessary changes to their practice.
CKS September 2022
During the month of September 2022, the following Clinical Knowledge Summaries were published or updated:
The Contraception-progestogen-only methods topic is new. All the other above topics have been reviewed and updated in line with NICE guidance with minor layout changes. The Depression topic has been updated with definitions of depression severity and amended options for treatment. The Psoriasis topic has been updated with recommendations on diagnosis and management of psoriasis in line with current evidence.
Clinicians can use the updated and new information when reviewing patients.
The information in the Prescribing News section has been adapted from the Prescribing Advice for GPs blog
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.
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.
Supply Issue Update for Primary and Secondary Care
Registered users can access the Medicines Supply Tool, which provides monthly drug availability updates for primary and secondary care produced by the Department for Health and Social Care (DHSC), on the Specialist Pharmacy Service(SPS) website.
Please note you must be registered with SPS, with the relevant permissions, and logged in to view this page. Click on ‘sign in’ in the top right hand.
Drug Tariff Price Changes
Drug tariff price changes are summarised as the top 10 price reductions and top 10 price increases since last month, the top 25 increases and decreases compared to three months ago, and the top 50 changes since last year.
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.
