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Products Miscellany and Supply Problems August 2016
Products
Product Information
Supply Now Available
Sacubitril
Sacubitril valsartan (Entresto®) is an
valsartan
angiotensin receptor neprilysin inhibitor and
(Entresto®)
is recommended as a treatment option for
patients with symptomatic heart failure in
line with NICE TA388.
Treatment should only be started by a heart
failure specialist with access to a
multidisciplinary heart failure team. However
it has been classed locally as an amber
drug and prescribing may be transferred to
primary care once titration to a stable
maintenance dose has been achieved.
New Product:
Fosfomycin 3g sachets are licensed for the
Monuril
treatment of acute lower uncomplicated
(fosfomycin) 3g urinary tract infections, caused by sensitive
granules for oral
pathogens in adult and adolescent females.
solution
It is also licensed for prophylaxis in
diagnostic and surgical transurethral
procedures.
Ergocalciferol
This new product is licensed for the
50 000 IU
treatment of vitamin D deficiency and the
Capsules
maintenance of vitamin D levels in adults
and the elderly.
General Information
How to get
HSCIC is the national provider of
Electronic
information, data and IT systems for health
Prescription
and social care.
Service (EPS)
Recently there has been a problem over a
service alerts
few days whereby the EPS system had
from the Health
“gone down” and GP practices were unable
and Social Care
to send their electronic prescriptions to
Information
community pharmacies and the pharmacies
Centre (HSCIC)
were unable to download the electronic
prescriptions for their patients.
For future reference, the following
information may be helpful for GP practices
and community pharmacies:
On the HSCIC site there is a link to the
Service Status page at
http://nww.hscic.gov.uk/servicemanagement/
status/, which clarifies any ongoing problems
with EPS in England.
RPS launches
ultimate guide
for pharmacists
working in care
homes
Public Health
England has
issued new
advice on
vitamin D
If you wish to receive High Severity Service
Incident (HSSI) communications via email or
SMS this can be done by completing the
form found at the following link
http://nww.hscic.gov.uk/servicemanagement/
status/subscribe/
The Royal Pharmaceutical Society (RPS)
has added to its ultimate guide series with a
new guide for pharmacists working in care
homes or for those who are interested in
starting in the role.
Public Health England has issued new
advice on vitamin D based on the
recommendations of the Scientific Advisory
Committee on Nutrition. Vitamin D and
Health report published on 21 July 2016
The advice notes that vitamin D is made in
the skin on exposure to UVB in sunlight but
since this is difficult to quantify a daily
dietary intake of 10 micrograms is being
recommended.
It is noted that in spring and summer the
Tin Orchel Medicines Management Team Southampton City CCG
Comments
For more information see statement from
DPC:
Sacubitril_valsartan_
DPC_statement_May_2016.docx
Locally, fosfomycin is an AMBER drug in our
Joint Formulary.
Recommendations are also made for children
under 5. Children from birth to 1 year old who
are breast feed should be given a daily
supplement containing 8.5 to 10 micrograms
of vitamin D. Formula fed children of this age
consuming 500ml or more each day do not
require a daily supplement because infant
formula is fortified with vitamin D. Children
aged 1 to 4 years should be given a daily
supplement containing 10 micrograms of
vitamin D. It is noted that low-income families
E-mail [email protected]
Products Miscellany and Supply Problems August 2016
majority of the population get enough
vitamin D through sunlight on the skin and a
healthy, balanced diet. In autumn and winter
months it is difficult for people to meet the 10
microgram recommendation from consuming
foods naturally containing or fortified with
vitamin D so people should consider taking a
daily supplement containing 10 micrograms
of vitamin D.
The advice also considers people whose
skin has little or no exposure to the sun, like
those in institutions such as care homes, or
who always cover their skin when outside
and recommends that they need to take a
supplement throughout the year.
Ethnic minority groups with dark skin, from
African, Afro-Caribbean and South Asian
backgrounds, may not get enough vitamin D
from sunlight in the summer and therefore
should consider taking a supplement all year
round.
Revised SPC:
Section 4.2 now advises that the tablets
Klaricid XL
should not be chewed or crushed.
(clarithromycin)
Additionally, specific advice on dosing in
500mg tablets
renal impairment has been added.
Revised SPC:
Section 4.4 has been updated to advise that
Dolmatil
sulpiride may increase prolactin levels.
(sulpiride)
Therefore, caution should be exercised and
tablets – all
patients with a history or a family history of
strengths
breast cancer should be closely monitored
during sulpiride therapy.
Specials information
can access vitamin D free of charge via
Healthy Start schemes.
Oral
Magnesium
supplementation
-an update and
reminder
It is recommended that a diagnosis and
correction of the primary cause of
hypomagnesaemia is identified as oral
magnesium (Mg) salts are not well absorbed
by the gastrointestinal system and can cause
diarrhoea. Possible causes include:
Drugs
proton pump inhibitors , diuretics, especially
loop and thiazide diuretics , ciclosporin ,
abusive use of laxatives , cancer
chemotherapy in particular cisplatin
Osmotic diuresis (diabetes)
Inherited Disorders
Lactation
Reduced absorption (Coeliac Disease,
chronic diarrhoea, short bowel syndrome,
malnutrition)
The reference magnesium range is 0.7
– 1.0 mmol/L.
For mild hypomagnesaemia Mg
=0.5mmol/L or moderate
hypomagnesium and asymptomatic
Mg< 0.5mmol/L consider
1st line :Magnesium aspartate dehydrateMagnasparte®
1-2 sachets daily=10-20mmol Mg
2nd line; Magnesium glycerophosphateYourMag® or Magnaphate®
2x4mmol tablet three times a day=24mmol
Mg
Please note that YourMag® and
Magnaphate® are unlicensed products and
should only be used for patients that cannot
use the sachets.
Tin Orchel Medicines Management Team Southampton City CCG
Clinicians should be aware of this new advice.
The advice consistently refers to "dietary
sources" of vitamin D including foods naturally
containing or fortified with vitamin D and
supplements. As such prescribing of
vitamin D purely for supplementation
following this advice should be resisted.
Patients should be encouraged to buy vitamin
D in these low supplementation doses at
reasonable costs.
For more information visit:
www.medicines.org.uk
For more information visit:
www.medicines.org.uk
.
E-mail [email protected]