Greater Glasgow and Clyde Medicines

Medicines Update

For all healthcare professionals across NHSGGC both in primary care and the acute sector.

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

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06/09/2023 announcement

Accessing GGC Clinical Guidelines via Medicines Update blogs and the Adult Therapeutics Handbook 

GGC Clinical Guidelines have migrated to the Right Decisions for Health and Care platform. As a result of the migration, direct links to GGC guidelines within Medicines Update blogs (and the Adult Therapeutics Handbook, GGC Medicines App) currently go to the homepage and not individual guidelines. This change was out with our control. 
Please note, there is a message on the homepage highlighting intermittent issues with the search function, therefore, if you cannot find a guideline via the search box, select the relevant category from the homepage or if the guideline still can't be found, contact
An update will be provided in due course.

Safe disposal of sharps waste in primary care

Posted: Friday, April 5, 2024

Category - Medicines Update

  • Many patients may need to use sharps, such as needles, syringes and fingertip lancing devices, to treat and manage their condition.

  • Sharps should never be disposed of in domestic waste, recycling, or in a container that is no longer needed, such as a drinks can or a bottle. This is potentially hazardous to anyone who comes into contact with the waste, including refuse collectors and members of the public.

  • To minimise the risk of needle stick injuries, a sharps bin, (e.g. SharpSafe® or Sharpsguard®) can be prescribed, which can be returned to the patient’s GP practice for safe disposal once full. GP practices can accept sharps containers independent of their source, however, sharps containers (with exception of needle exchange) should not be returned to community pharmacies.


Opioid Induced Adrenal Insufficiency (OIAI)

Posted: Thursday, March 21, 2024

Category - Medicines Update

Key messages

  • Adrenal insufficiency (as highlighted in the NHSGGC Non-Malignant Pain Opioid guideline) is a possible side effect of long-term opioid prescribing.
  • Despite the fact that opioids are clearly linked to various endocrinopathies, OIAI has not been well-researched and is thought to be largely under-recognised in practice.
  • Routine testing is not recommended if the patient is well. However, if the patient has symptoms of adrenal insufficiency (e.g. fatigue, weight loss, low blood pressure, fainting, increased thirst, low mood) then an early morning cortisol test is recommended, with referral to endocrinology if cortisol is low
  • OIAI has been reported with wide ranges in median duration of use, median morphine equivalent daily dose and estimated prevalence.
  • As there is no specific dose or duration of treatment associated with the development of OIAI the risk is expected to be higher with the cumulative exposure to the opioid.

Key Medicine Shortages – February 2024

Posted: Tuesday, February 27, 2024

Category - Medicines Update

Key Medicine Shortages February 2024 here


GLP-1 Receptor Agonists, Lamotrigine 5mg dispersible tablets, Tresiba® (insulin degludec) FlexTouch 100units/ml solution for injection 3ml pre-filled pens and Phenytoin sodium 100mg capsules (Accord)


NHS Greater Glasgow and Clyde Interstitial Lung Disease Medication Service

Posted: Monday, January 29, 2024

Category - Medicines Update

Key messages

  • Use of antifibrotic medicines (nintedanib (Ofev®), pirfenidone) is restricted to
    specialist initiation and use for the management of fibrotic Interstitial Lung Disease
    (ILD) and has to be approved by the ILD Multi-Disciplinary Team (MDT)
  • Supply of these medicines and required monitoring is via the pharmacist led ILD
    medication service. Medication is supplied directly to patients via homecare
  • Respiratory consultants can request initiation, titration and monitoring of
    immunosuppressant medications for ILD patients such as azathioprine, methotrexate,
    mycophenolate, prednisolone via this service. Clear communication will be made with
    primary care with regards to ongoing medication supply.
  • The pharmacist ILD team can be contacted via email:, or by telephone on 07977 154764. This is staffed Monday to Friday and replies are normally within 24 hours.