Greater Glasgow and Clyde Medicines

• The side effect profile of clozapine means it is subject to mandatory processes and monitoring which are intended to ensure patient safety.
• Concurrent use of medications known to cause neutropenia are contraindicated with clozapine.
• In the event of an individual prescribed clozapine requiring cytotoxic treatment, a special treatment plan must be established to manage the contraindicated combination and allow clozapine treatment to continue.

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Apixaban has replaced edoxaban as the preferred direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (AF) with one or more risk factors (excluding mechanical valve replacement or moderate-severe mitral stenosis).

An additional regulatory change in January 2024 for oral valproate medicines, means that:

• Valproate must not be started in new patients (male or female) younger than 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment, or there are compelling reasons that the reproductive risks do not apply.

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Includes:

Diazepam 10mg/2.5ml rectal solution tubes, Guanfacine (Intuniv^®) 2mg and 3mg modified release tablets, Fiasp^® (insulin aspart) FlexTouch 100units/ml solution for injection 3ml pre-filled pens, Levemir InnoLet^® (insulin detemir) 100units/ml solution for injection pre-filled disposable devices, Insulatard InnoLet^® (insulin isophane human) 100units/ml suspension for injection 3ml pre-filled disposable devices, Monomil^® XL (isosorbide mononitrate) 60mg modified release tablets, Methadone 5mg tablets, Pabrinex^® IV and IM injections, and Salbutamol 2.5mg/2.5ml nebules

Sitagliptin is now the preferred dipeptidylpeptidase-4 (DPP4) inhibitor in NHSGGC, replacing alogliptin.

This post summarises the latest NHS Greater Glasgow and Clyde decisions relating to new medicines assessed by SMC and considered by the Area Drug and Therapeutics Committee (ADTC) and uses a nationally developed format specifically aimed for patients and the public.

For full details of the medicines included in this post that are available for use, including any restrictions on prescribing, please see the relevant entry in the GGC Formulary

The NHSGGC Opioid Prescribing for Chronic Non Malignant Pain Guideline has been reviewed and updated.

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