Memos and Alerts
MHRA information on TPP SystmOne and QRISK®2
15 June 2016
Following an investigation into the QRISK®2 Calculator in SystmOne run by TPP, code mapping errors were identified and as a precaution the tool was temporarily disabled. The MHRA have now confirmed that the problem has been fixed.
Orphenadrine 50mg tablets unavailable
10 June 2016
Disipal® (Orphenadrine) 50mg tablets have been discontinued and are no longer available. There is a generic version of Orphenadrine 50mg tablets but they are also currently unavailable due to a manufacturing problem (Not expected to be in stock before October 2016). We would advise all prescribers to review any patient currently prescribed orphenadrine.
Death Related to use of Fentanyl Patches
8 June 2016
Death related to use of fentanyl patches – reminder that exposure of the application site to external heat sources can increase absorption of the drug from the patch, resulting in increased plasma concentrations of fentanyl and buprenorphine and increased risk of opioid toxicity.
Vaccine Supply Update
MenC vaccine ordering reminder – programme ceases 1st July 2016.
Nimenrix – check expiry dates.
Primary infant vaccine – Infanrix IPV Hib available to order with no restriction on volume.
Updated PGDs: Measles Mumps and Rubella (MMR) Vaccine and Combined Low Dose Diphtheria, Tetanus and Inactivated Polio (Td/IPV) (Revaxis) Vaccine
The current Patient Group Directions for Measles Mumps and Rubella (MMR) Vaccine and Combined Low Dose Diphtheria, Tetanus and Inactivated Polio (Td/IPV) (Revaxis) Vaccine have been updated.
Updated PGDs: Boostrix-IPV/ Repevax, Pneumococcal Vaccines, Hib/MenC Vaccine
The current Patient Group Directions for Boostrix-IPV, Pneumococcal (PPV and PCV) and Hib/MenC have been updated.
Sacubitril valsartan (Entresto®) – Heart failure
NICE have recently published their advice on use of Sacubitril valsartan (Entresto®) for the treatment of symptomatic chronic heart failure with reduced ejection fraction.
Entresto® includes both a neprilysin inhibitor (sacubitril) and an angiotensin II receptor blocker (ARB; valsartan).
The complementary cardiovascular benefits of Entresto in heart failure patients are attributed to the enhancement of peptides that are degraded by neprilysin, such as natriuretic peptides (NP), by LBQ657 and the simultaneous inhibition of the effects of angiotensin II by valsartan.
A reminder about lithium
Lithium is prescribed and monitored in primary care under shared care arrangements. If you are concerned about a patient’s lithium level, renal function or thyroid function, contact the specialist mental health team for advice
Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adults
Transgender and non-binary people will spend a relatively short time under the care of a specialist Gender Identity Clinic. General Practitioners therefore have an important role in the ongoing care of patients when they no longer have a need for specialised gender identity services. The prescribing and monitoring of hormone therapy can be carried out safely in primary care without specialist input, though Gender Identity Clinics are encouraged to provide support to individual General Practitioners when this is requested.