73 updates

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Psychiatry

  1. Letters and drug alerts sent to healthcare professionals in April 2020

    A summary of letters and drug alerts recently sent to healthcare professionals.

  2. Letters and drug alerts sent to healthcare professionals in March 2020

    A summary of letters and drug alerts recently sent to healthcare professionals.

  3. Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression

    Benzodiazepines and opioids can both cause respiratory depression, which can be fatal if not recognised in time.

  4. Letters and drug alerts sent to healthcare professionals in February 2020

    Letters were sent on Typhim Vi vaccines, Mepact (mifamurtide), and Xeljanz (tofacitinib) and an alert issued to recall Emerade 150 microgram adrenaline pens.

  5. Valproate (Epilim▼, Depakote▼) pregnancy prevention programme: updated educational materials

    In January 2020, healthcare professionals received updated educational materials to support the valproate pregnancy prevention programme.

  6. Letters and drug alerts sent to healthcare professionals in January 2020

    Letters were sent about methotrexate, modafinil, Ecalta, Picato, Nexplanon, valproate medicines, e-cigarettes, and Lemtrada.

  7. Letters and drug alerts sent to healthcare professionals in December 2019

    Letters were sent about Insuman insulin products, mecasermin, and valproate medicines.

  8. Letters and drug alerts sent to healthcare professionals in September 2019

    Letters were issued about parenteral nutrition products, ranibizumab, ingenol mebutate gel, adrenaline auto-injectors, and fingolimod.

  9. Montelukast (Singulair): reminder of the risk of neuropsychiatric reactions

    Prescribers should be alert for neuropsychiatric reactions in patients taking montelukast and carefully consider the benefits and risks of continuing treatment if they occur.

  10. Letters and drug alerts sent to healthcare professionals in July 2019

    Letters were sent about Oncaspar▼ (pegaspargase), Ketalar (ketamine) injection, and Elmiron (pentosan polysulfate sodium).

  11. Letters and drug alerts sent to healthcare professionals in June 2019

    Letters were sent about Myocrisin (sodium aurothiomalate), Cerliponase alfa (Brineura▼), Darzalex▼(daratumumab), retinoids▼, and febuxostat (Adenuric).

  12. Oral retinoid medicines▼: revised and simplified pregnancy prevention educational materials for healthcare professionals and women

    New prescriber checklists, patient reminder cards, and pharmacy checklists are available to support the Pregnancy Prevention Programme in women taking acitretin, alitretinoin, and isotretinoin.

  13. Letters and drug alerts sent to healthcare professionals in April 2019

    Letters were sent about alemtuzumab (Lemtrada), Selenase (sodium selenite pentahydrate), and Erelzi▼ (etanercept).

  14. Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme

    Ongoing patient survey data suggest that more effort is needed by clinicians to achieve full and timely compliance with the valproate Pregnancy Prevention Programme and meet the goal to rapidly reduce and eventually eliminat…

  15. Belimumab (Benlysta▼): increased risk of serious psychiatric events seen in clinical trials

    Clinical trials, including interim findings from a randomised trial, show an increased risk of depression, suicidal ideation or behaviour, or self-injury in patients with systemic lupus erythematosus receiving belimumab comp…

  16. Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April

    As of 1 April 2019, pregabalin and gabapentin are controlled under the Misuse of Drugs Act 1971 as Class C substances and scheduled under the Misuse of Drugs Regulations 2001 as Schedule 3.

  17. Letters and drug alerts sent to healthcare professionals in March 2019

    Letters were sent about Xeljanz▼ (tofacitinib), ranitidine, Nulojix (belatacept), fluoroquinolone antibiotics, Genvoya▼, Stribild▼, Tybost, and belimumab (Benlysta▼).

  18. Tapentadol (Palexia): risk of seizures and reports of serotonin syndrome when co-administered with other medicines

    Tapentadol may increase seizure risk in patients taking other medicines that lower seizure threshold, for example, antidepressants and antipsychotics.

  19. Valproate medicines: are you acting in compliance with the pregnancy prevention measures?

    Although use of valproate medicines in female patients continues to slowly decline, there is wide variation in prescribing between Clinical Commissioning Groups (CCGs).

  20. Letters and drug alerts sent to healthcare professionals in October 2018

    Letters were sent to healthcare professionals about Jext adrenaline autoinjectors, rivaroxaban, Ozurdex 700 micrograms intravitreal implant, sildenafil, hydrochlorothiazide, and Epilim Chronosphere (sodium valproate).

  21. Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers

    Valproate medicines must not be used in women of childbearing potential unless the Pregnancy Prevention Programme is in place.

  22. Daclizumab beta (Zinbryta▼): risk of immune-mediated encephalitis – some cases several months after stopping treatment

    Monitoring for encephalitis should continue for 12 months following discontinuation of daclizumab.

  23. Letters and drug alerts sent to healthcare professionals in July 2018

    Letters were sent about valproate medicines, atezolizumab (Tecentriq▼), and nusinersen (Spinraza▼).

  24. Medicines taken during pregnancy: please report suspected adverse drug reactions, including in the baby or child, on a Yellow Card

    Report to the Yellow Card Scheme suspected adverse reactions associated with medicines taken during pregnancy experienced by women or the baby or child.

  25. Letters sent to healthcare professionals in June 2018

    Letters were sent about Cetrotide (cetrorelix acetate), Eperzan▼(albiglutide), darunavir/cobicistat, Keytruda▼ (pembrolizumab), Denzapine (clozapine) 50 mg/mL oral suspension, and Bleo-Kyowa (bleomycin sulphate).

  26. Valproate medicines (Epilim▼, Depakote▼): Pregnancy Prevention Programme materials online

    Use materials online now and hardcopies arriving over the coming weeks by post to ensure women and girls of childbearing potential on valproate medicines meet the requirements of the Pregnancy Prevention Programme.

  27. Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met

    Valproate medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place.

  28. Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus

    If constipation occurs during treatment with clozapine (Clozaril, Denzapine, Zaponex), it is vital that it is recognised and actively treated.

  29. Loperamide (Imodium): reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse

    There have been reports of cardiac events including QT prolongation, torsades de pointes, and cardiac arrest in patients who have taken high or very high doses of loperamide as a drug of abuse or for self-treatment of opioid…

  30. Finasteride: rare reports of depression and suicidal thoughts

    We have received reports of depression and, in rare cases, suicidal thoughts in men taking finasteride 1 mg (Propecia) for male pattern hair loss.

  31. Valproate and developmental disorders: new alert asking for patient review and further consideration of risk minimisation measures

    Babies born to mothers who take valproate medicines (Epilim▼, Depakote▼) during pregnancy have a 30–40% risk of developmental disability and a 10% risk of birth defects.

  32. Apremilast (Otezla ▼): risk of suicidal thoughts and behaviour

    There is an increased risk that some patients may experience psychiatric symptoms with apremilast, including depression and suicidal thoughts.

  33. Letters sent to healthcare professionals in November 2016

    A summary of recent letters sent to relevant healthcare professionals, to inform them of updated safety information.

  34. Citalopram: suspected drug interaction with cocaine; prescribers should consider enquiring about illicit drug use

    Possible illicit drug use should be considered when prescribing medicines that have the potential to interact adversely.

  35. Meprobamate: licence to be cancelled

    Following an EU wide review of meprobamate, the remaining licence holder in the UK has ceased manufacturing and the licence will be cancelled by the end of 2016.

  36. Letters sent to healthcare professionals in February 2016

    In February 2016, a letter was sent to healthcare professionals regarding medicines containing valproate.

  37. Valproate and risk of abnormal pregnancy outcomes: new communication materials

    Children exposed to valproate in utero are at high risk of developmental disorders and congenital malformations.

  38. Hydroxyzine (Atarax, Ucerax): risk of QT interval prolongation and Torsade de Pointes

    The maximum adult daily dose of hydroxyzine is now 100 mg.

  39. Corticosteroids e-learning module launched

    The new module helps clinicians understand how to identify, manage and avoid side effects when using corticosteroids.

  40. Drugs and driving: blood concentration limits set for certain drugs

    We remind you that a new offence will be enforced from 2 March 2015 in England and Wales.

  41. Medicines related to valproate: risk of abnormal pregnancy outcomes

    Children exposed in utero to valproate are at a high risk of serious developmental disorders (in up to 30-40% of cases) and/or congenital malformations (in approximately 10% of cases).

  42. Isotretinoin (Roaccutane): reminder of possible risk of psychiatric disorders

    Warn patients and family, monitor patients for signs of depression

  43. Agomelatine (Valdoxan): risk of liver toxicity

    Reminder to test liver function before and during treatment.

  44. Drugs and driving: clarification for Wales, Scotland, and Northern Ireland

    The new offence introduced in July does not apply in Northern Ireland nor replace any existing offences of driving.

  45. Drugs and driving: blood concentration limits to be set for certain controlled drugs in a new legal offence

    The Department for Transport has introduced a new offence of driving with certain controlled drugs above specified limits in the blood; this is likely to come into force on 2 March 2015.

  46. Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery

    Cases of intraoperative floppy iris syndrome (IFIS) during cataract surgery have been reported in patients taking the atypical antipsychotics risperidone or paliperidone.

  47. Sodium valproate: Risk of neurodevelopmental delay in children following maternal use

    Not for use in pregnancy unless there is no effective alternative.

  48. Mefloquine: strengthened warnings on neuropsychiatric side effects

    A recent review of the prescribing information has led to strengthened warnings and new measures to help minimise risks. To minimise the risk of these adverse reactions, mefloquine must not be used for chemoprophylaxis in…

  49. Agomelatine (Valdoxan/ Thymanax): risk of dose-related hepatotoxicity and liver failure

    Liver function tests should be carried out at treatment initiation, during treatment, and also when the dose is increased.

  50. Antipsychotics: initiative to reduce prescribing to older people with dementia

    Concerns over recent years about the use of antipsychotics to treat the behavioural and psychological symptoms of dementia (BPSD).