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.

Cost efficiency - Prednisolone standard 5mg tablets preferred formulation in GGC

Posted: Wednesday, January 22, 2025

Category - Medicines Update

Key messages

  • The NHSGGC Medicines Cost and Efficiency Group (MCEG) has identified that the cost of prednisolone 5mg soluble tablets in primary care is almost 50 times more than standard 5mg tablets. Soluble tablets are also more expensive than other prednisolone formulations (see Table 1 below).
  • Prednisolone 5mg soluble tablets should not be prescribed or ordered, unless standard tablets and alternative formulations are not suitable (see alternatives below).
  • Standard 5mg prednisolone tablets will disperse in water for patients who are unable to swallow whole tablets. Some brands of prednisolone tablets will disperse almost immediately, and others may take two to five minutes. Please note, although this is an off label use of a licensed medicine, NHSGGC have endorsed this practice. Refer to section 5.4 NHSGGC unlicensed medicines policy for information on additional responsibilities taken when administering and prescribing unlicensed or off label medicines.
  • If prednisolone is to be administered via a fine bore feeding tube (e.g. an NJ tube) that may be at risk of blockage, prednisolone oral solution or prednisolone soluble tablets can be used. Please note, this is also an off label use of the solution and soluble tablets. Contact pharmacy for advice if required.  

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What’s new in migraine? Oral Calcitonin Gene-Related Peptide Antagonists

Posted: Tuesday, November 26, 2024

Category - Medicines Update

  • Calcitonin Gene-Related Peptide (CGRP) is a neuropeptide which is involved in the pathogenesis of migraine. 
  • Two new oral CGRP small molecule antagonists – rimegepant and atogepant - have recently been added to the GGC Adult Medicines Formulary and can be initiated by non-specialists in primary care.
  • Patients must have had prior failure of three or more migraine preventative treatments before rimegepant or atogepant can be considered.
  • This blog summarises the key information on these two medicines and some common clinical questions which may occur. For full details on when to prescribe, refer to NHSGGC Guidance on Pharmacological Prophylaxis of Migraine in Adults

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NHS Prescribing at request of private healthcare provider

Posted: Thursday, November 21, 2024

Category - Medicines Update

If individuals opt for private healthcare treatment or assessment, they are still entitled to NHS services. The NHSGGC Central Prescribing Team are often asked by GPs what they should do if a patient requests a medicine following consultation with a private healthcare provider. This blog provides some advice.

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Polypharmacy Review in Adults living with Moderate to Severe Frailty – Use of Cognitive enhancers, Analgesics and Anti-emetics in Patients with Dementia

Posted: Friday, November 1, 2024

Category - Medicines Update

Key messages

  • Do not routinely stop cognitive enhancers as may cause a decline in symptom control.
  • Pain can present as a change in behaviour or distress in patients with dementia.
  • NSAIDs should ideally be avoided in older people due to increased risk of adverse effects.
  • Anti-emetics can have a high anticholinergic burden - review indication and consider stopping if appropriate.

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