Greater Glasgow and Clyde Medicines

• Clostridioides difficile infection (CDI) has been associated with PPI use.
• The NHSGGC guideline on Management of Suspected or Proven Clostridioides difficile Infection (CDI) in Adults advises stopping gastric acid suppression (e.g. PPIs) where possible.

• In recent years there have been reports of a link between PPI use and pneumonia, however, evidence is conflicting and therefore there are no NHSGGC guidelines for the management of PPIs in patients with pneumonia.

MHRA Drug Safety Update December 2022

MHRA Drug Safety Update November 2022

• Metformin can commonly reduce vitamin B12 levels in patients, which may lead to vitamin B12 deficiency. Refer to MHRA Drug Safety Update here.

• B12 deficiency risk increases with higher metformin doses, longer treatment duration and patients with a risk of B12 deficiency (see below for additional risk factors)

Guideline News October 2022

Key Medicine Shortages – November 2022

Key messages

• Refer to available guidance for information on how to alleviate symptoms of the menopause (see links in further information below)
• Refer to the NHSGGC Adult Medicines Formulary for preferred hormone replacement therapy (HRT) options
• If ‘off-label’ testosterone is being considered for low sexual desire (when HRT alone is not effective), refer to NICE and British Menopause Society (BMS) guidance and the NHSGGC Unlicensed Medicines Policy