Greater Glasgow and Clyde Medicines

Medicines Update

GGC Medicines Update is a series of blogs with important medicines related messages relevant to all healthcare professionals across GGC.

Please note, Medicines Update blogs are correct at the time of publication.

Medicines Update blogs remain on the website for 4 years. If you would like a copy of a blog published more than 4 years ago, please contact ggc.medicines.update@nhs.scot

Click here for a promotional poster on Medicines Update and here for an animation on the Communications subcommittee of ADTC responsible for the development of Medicines Update.

If you would like to contribute to Medicines Update, click here for further information and here for a guide to blog writing. When you email the committee to discuss writing a blog, you will be sent a checklist to complete prior to submitting the blog for review.

Updated NHSGGC guideline: Treating asthma in adults (16 years and older) in primary care

Posted: Friday, May 23, 2025

Category - Medicines Update

Click here to access the full blog

  • Asthma is an inflammatory condition therefore the preferred pathway uses one inhaler combining inhaled corticosteroid (ICS) with formoterol, a quick acting reliever. There is therefore no need for a salbutamol inhaler. 
  • It represents a step away from as required (prn) salbutamol and other short-acting beta-2 agonist (SABA) devices for the relief of asthma symptoms. 
  • This preferred approach is referred to as the AIR/MART pathway (anti-inflammatory reliever / maintenance and reliever therapy). 
  • Patients can be moved to an ICS-containing device in the AIR/MART pathway, as they also contain the long-acting beta-2 agonist (LABA) formoterol, which has an onset of action comparable to SABAs. Current ICS devices licensed contain either budesonide (AIR or MART) or beclometasone (MART only). 
  • If patients are stable, there is no need to switch them to the AIR/MART pathway – consider switching opportunistically at a routine review. 
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Metalyse® 25mg (5000 units): new agent of choice for thrombolysis in acute ischaemic stroke

Posted: Thursday, May 22, 2025

Category - Medicines Update

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  • Metalyse® (tenecteplase) 25mg (5,000 units) has replaced alteplase as the agent of choice for thrombolysis in acute ischaemic stroke patients in NHSGGC (see GGC guideline). Clinical trials have shown Metalyse® to be non-inferior to alteplase for this indication.
  • Metalyse® is RESTRICTED to specialist use and should ONLY be used by local stroke teams who have undergone training. 
  • It is anticipated that Metalyse® will reduce door-to-needle times and facilitate transfer of patients to the hyper-acute stroke ward for ongoing management and monitoring.
  • Metalyse® 25mg (5,000 units) is licensed only for acute ischaemic strokes. Be aware that Metalyse® 50mg (10,000 units) is available and is licensed only for acute myocardial infarction. The formulations should not be used interchangeably.
  • If you work in an area that uses Metalyse®, please ensure that you are aware of the differences between the two products, i.e. different indications and licensing.
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Patient Safety: The dangers of co-prescribing opioids and benzodiazepines

Posted: Friday, May 9, 2025

Category - Medicines Update

To access the full blog via Microsoft Sway, click here

In March 2020 the MHRA issued a reminder notice highlighting the dangers associated with co-prescribing of benzodiazepines (B-Zs) and opioids. This was prompted by a coroner’s report following the death of a man prescribed clonazepam and, among other drugs, the opioid methadone. His death was attributed to the combination causing respiratory depression.

The GGC clinical guideline Opioid prescribing for chronic non-malignant pain advises “do not prescribe opioids to patients currently taking B-Zs”. Co-prescribing has additive effects in the central nervous system (CNS) leading to increased sedation, impaired alertness, reduced motor response and respiratory depression.

Despite the risks, Torrance et al 2018 found opioid prescribing in Scotland was increasing and co- prescribing of B-Zs was common.

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Lidocaine Plasters – Reducing Inappropriate Prescribing. Update on Progress

Posted: Thursday, April 17, 2025

Category - Medicines Update

To access the full blog via Microsoft Sway, click here

Key messages:

  • Lidocaine plasters are now non-formulary in NHSGGC.
  • Prescribing data shows a sustained downward trend in the number of patients prescribed lidocaine plasters, with the associated reduction in spend within NHSGGC.
  • April 2024 – January 2025  - there has been a 48.78 % reduction in the number of patients prescribed lidocaine plasters in Primary Care and a 47.41% reduction in spend.
  • Reducing inappropriate prescribing of lidocaine plasters has been a focus of the NHSGGC Cost Efficiency Workplan since April 2024 and will continue to be a focus for 2025/26.
  • Continue to review regularly with trials of reduction/cessation.
  • Patients who have been using lidocaine plasters for more than 6 months, should trial stopping.
  • De-prescribe in all patients where possible.
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