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Darlington, DDES and North Durham Update October 2014

Clozapine – aide memoire for General Practitioners

Clozapine is an antipsychotic used in the treatment of schizophrenia when other antipsychotics have not worked. It may also be used for psychotic disorders occurring in Parkinson’s disease when standard treatment has failed. Clozapine is classed as a RED drug which means it must only be prescribed by secondary care mental health services. Prescribing responsibility will not transfer to GPs under any circumstances. However GPs should record clozapine on the patient’s medication record so that a complete list of medication is available. More information can be found at

Update APC formulary process

This has been reviewed by the APC and can be found at

EPS2 update

Most North Durham GP practices are now live with EPS2, DDES CCG are just commencing the process, and in Darlington CCG the roll out is now complete with all practices live.

Blood glucose testing strip update

This latest memo can be found at

MHRA drug safety updates you may have missed

Strontium ranelate – cardiovascular risk—restricted indication and new monitoring requirements –

St John’s Wort: interaction with hormonal contraceptives, including implants—reduced contraceptive effect –

Combined hormonal contraceptives and venous thromboembolism: review confirms risk is small—consider risk factors and remain vigilant for signs and symptoms –


MHRA Drug Safety Update June 2014 (Issue 11) –

Combination use of medicines from different classes of renin-angiotensin system blocking agents: risk of hyperkalaemia, hypotension, and impaired renal function—new warnings

Ivabradine: emerging clinical trial evidence of increased cardiovascular risk—carefully monitor for bradycardia

E-learning modules on adverse drug reactions

MHRA Drug Safety Update July 2014 (Issue 12) –

Drugs and driving: blood concentration limits to be set for certain controlled drugs in a new legal offence

Transdermal fentanyl “patches”: reminder of potential for life-threatening harm from accidental exposure, particularly in children

Medicines learning modules – Opioids