-
Medicines or herbal remedies that induce CYP3A4 enzymes reduce blood levels of levonorgestrel, which may reduce emergency contraceptive efficacy.
-
A signal of increased lower limb amputation (primarily of the toe) in people taking canagliflozin compared with placebo in a clinical trial in high cardiovascular risk patients is currently under investigation.
-
There have been rare reports of Nexplanon implants having reached the lung via the pulmonary artery. An implant that cannot be palpated at its insertion site in the arm should be located as soon as possible and removed at th…
-
In May 2016, letters were sent regarding Nexplanon (etonogestrel implant) and ERWINASE.
-
In April 2016, letters were sent regarding canagliflozin (Invokana▼, Vokanamet▼), BCR-ABL tyrosine kinase inhibitors, pomalidomide (Imnovid▼), and retigabine (Trobalt)
-
Test for raised ketones in patients with ketoacidosis symptoms, even if plasma glucose levels are near-normal.
-
In March 2016, letters were sent regarding SGLT2 inhibitors, insulin lispro, natalizumab, noradrenaline, radium-223 dichloride, aflibercept and idelalisib.
-
In February 2016, a letter was sent to healthcare professionals regarding medicines containing valproate.
-
Children exposed to valproate in utero are at high risk of developmental disorders and congenital malformations. Use the new communication materials below to discuss these risks with patients
-
Levonorgestrel-releasing intrauterine systems should always be prescribed by brand name because products have different indications, durations of use, and introducers.
-
Mycophenolate mofetil and its active metabolite mycophenolic acid are associated with a high rate of serious birth defects and increased risk of spontaneous abortion.
-
Osteonecrosis of the external auditory canal has been reported very rarely (fewer than 1 in 10 000 patients) with bisphosphonates, mainly in association with long-term therapy (2 years or longer).
-
In November, letters were sent regarding thalidomide, mycophenolate mofetil, nicorandil, InductOs, and dimethyl fumarate
-
Mirabegron is now contraindicated in patients with severe uncontrolled hypertension; advice about regular monitoring is being introduced because of cases of severe hypertension.
-
A letter was sent to healthcare professionals about mirabegron for symptomatic treatment of urgency, increased
micturition frequency, or urgency incontinence.
-
Patient reminder cards about the risk of osteonecrosis of the jaw are being introduced; denosumab 120 mg is now contraindicated in patients with unhealed lesions from dental or oral surgery.
-
Test for raised ketones in patients with acidosis symptoms, even if plasma glucose levels are near-normal.
-
EU review confirms that the cardiovascular risk of high-dose ibuprofen (≥2400mg/day) is similar to COX 2 inhibitors and diclofenac.
-
The most important risk factors for uterine perforation are insertion during lactation and insertion in the 36 weeks after giving birth. Before inserting an IUS or IUD, inform women of the risk and the symptoms of perforatio…
-
Several new high strength insulin products are now on the market. The European Medicines Agency is consulting on guidance to minimise the risk of medication error.
-
Last month, letters were sent regarding ketoconazole HRA and radium-223 dichloride (Xofigo).
-
The licence-holder of ferumoxytol has voluntarily withdrawn it from the UK market for commercial reasons.
-
The new module helps clinicians understand how to identify, manage and avoid side effects when using corticosteroids.
-
Since November 2014, letters were sent regarding vismodegib (Erivedge ▼), chlorhexidine solutions, carbocisteine oral liquid (Mucodyne Paediatric 125mg/5ml), regadenoson (Rapiscan), a parenteral nutrition emulsion (Triomel),…
-
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).
-
From October 2014 Dexamethasone 4 mg/ml injection (Organon Laboratories Limited) will be replaced by Dexamethasone 3.8 mg/ml solution for injection (Aspen Pharma Trading Limited).
-
Minimising the risk of osteonecrosis of the jaw; monitoring for hypocalcaemia.
-
New recommendations are being introduced to minimise the risk of serious hypersensitivity reactions with ferumoxytol.
-
Emergency contraceptives remain suitable for all women regardless of the woman’s weight or body mass index (BMI).
-
New warnings due to risk of hyperkalaemia, hypotension, and impaired renal function have been agreed following an EU-wide review.
-
Reporting suspected adverse reactions experienced by the woman or child associated with medicines taken during pregnancy.
-
Non-hormonal or progestogen-only contraception should be considered in some situations.
-
St John’s wort interacts with hormonal contraceptives reducing the effectiveness and increasing the risk of unplanned pregnancy.
-
Restricted indication and new monitoring requirements.
-
A review of the latest evidence on the risk of thromboembolism advises to consider risk factors and remain vigilant for signs and symptoms.
- the risk of blood clots with all low-dose CHCs is small
- there is good evid…
-
Not for use in pregnancy unless there is no effective alternative.
-
Use has been restricted to 48 hours’ maximum parenteral use under specialist supervision, after a European safety review.
-
Clarification of advice on new recommendations regarding initial test dose.
-
All products to be named and prescribed as caffeine citrate.
-
New strengthened recommendations to manage and minimise risk.
-
The risk of foetal malformation with oral retinoids is extremely high, even when used at a low dose or for a short time during pregnancy. All oral retinoids have an associated Pregnancy Prevention Programme (PPP), which is s…
-
Updated prescribing advice provided.
-
Recent interruption to the supply of liothyronine 20 microgram tablets from Amdipharm Mercury.
-
liver-function testing recommended in patients with symptoms that may indicate liver injury.
-
Care needed to minimise risk of error, including training for patients.
-
The maximum recommended dose for simvastatin in conjunction with amlodipine and diltiazem is now 20 mg/day.
-
There have been reports of acute pancreatitis associated with drugs in the dipeptidylpeptidase-4 (DPP-4) inhibitor class of antidiabetic agents (‘gliptins’).
-
Calcitonin-containing medicines should no longer be used in treatment of osteoporosis.
-
Updated contraindications and maximum dose recommendations when taken with a number of other medicines.
-
Careful monitoring of serum sodium important, co-administration of other drugs that may increase serum sodium not recommended.