Greater Glasgow and Clyde Medicines

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.

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

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Guideline News March 2024 here

In January 2024, the MHRA issued an alert on regulatory action taken to update the indications for all systemic fluoroquinolones to state they should only be used when other commonly recommended antibiotics are inappropriate

• 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.