Medicines Information

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates medicines, medical devices and blood components for transfusion in the UK

The MHRA issue regular Drug Safety Updates advising on the latest advice for medicines users. Some of the recent updates include:

Fostair to Luforbec switch

The primary care team in this practice are continually reviewing prescribing to provide patients with appropriate, high quality and cost effective medications for their conditions. We are keen to ensure that all our patients receive the best quality treatment whilst making the best use of NHS resources available to us.

Recently there have been a number of new inhalers released onto the market and the local NHS inhaler guidance has been updated with some of these new products.

If you were previously prescribed Fostair® pMDI inhaler this combination inhaler has changed to Luforbec® pMDI inhaler

This product contains Beclometasone dipropionate and formoterol fumarate. These inhalers are equivalent and contain exactly the same drugs at the same strength. You will notice a slight difference in the colour of the inhaler device and dust cap however they are used in exactly the same way. If you currently use a spacer device you should continue to do so.

Lurforbec is now the preferred formulary inhaler as the medication is the same but the inhaler is more cost effective for the NHS and has a lower carbon foot print 65.4g vs 93.7g CO2eq per puff

Inhalation technique for these type of inhalers is “SLOW and STEADY”. Please see ASTHMA UK inhaler technique resources https://www.asthmaandlung.org.uk/living-with/inhaler-videos . You should continue to take the same dose as advised by your doctor or nurse. Asthma is a condition that needs reviewed regularly even if you feel well as a severe asthma attack can happen at any time without warning. Please remember to attend your annual asthma review at the practice and take your inhalers with you.

However if you have any questions or concerns, please do not hesitate to contact the practice if you would like to speak to the practice pharmacist or your GP.

Pregabalin (Lyrica): findings of safety study on risks during pregnancy

April 2022 - A new study has suggested Pregabalin may slightly increase the risk of major congenital malformations if used in pregnancy. Patients should continue to use effective contraception during treatment and avoid use in pregnancy unless clearly necessary.

Patients who are planning a pregnancy or who become pregnant during treatment should make an appointment to discuss their health condition and any medicines they are taking

More information can be found HERE

Amiodarone (Cordarone X): reminder of risks of treatment and need for patient monitoring and supervision

March 2022 - Amiodarone is used to treat certain types of abnormal heart rhythm, including atrial fibrillation and tachyarrhythmias (heart beats unevenly or too fast). Treatment should be initiated under hospital or specialist supervision and in accordance with clinical guidance.

Amiodarone is associated with serious adverse effects in several organ systems including the eyes, gastrointestinal tract, nerves, skin, thyroid, lungs, heart, and liver. Amiodarone has a long plasma half-life of around 50 days, meaning that any adverse effects may persist for a month (or more) after treatment has stopped. Patients must be monitored closely during treatment

Advice for patients and carers:

Always read the patient information leaflet provided with your medicines and follow the advice on other medicines to avoid and what to do if you have a side effect.

Your doctor may perform tests of your blood, lungs, heartbeat, and eyes before and during treatment – it’s important to have these tests because they can identify if there’s a problem. During treatment blood tests are advised every 6 months.

Stop taking amiodarone and see a doctor or go to a hospital straight away if you experience any of the following during treatment or in the period after stopping amiodarone:

New or worsening shortness of breath or coughing that will not go away
Yellowing of the skin or eyes (jaundice), feeling tired or sick, loss of appetite, stomach pain, or high temperature
Weakness, weight loss or weight gain, heat or cold intolerance, hair thinning, sweating, changes in menstrual periods, swelling of the neck (goitre), nervousness, irritability, restlessness, or decreased concentration
Your heartbeat becomes even more uneven or erratic, or becomes very slow
Any loss of eyesight

NHS Emergency Steroid card

September 2020 - Recently issued National guidance promotes a patient-held Steroid Emergency Card to help healthcare staff identify patients with adrenal insufficiency and provide information on emergency treatment.

This means that there are now 2 types of steroid alert card a patient may be required to carry:

1. A steroid TREATMENT card (blue card)

This carries a series of instructions for the patient and informs healthcare professionals to whom the patient shows the card. The card should be carried when a patient is taking ORAL steroids. Patients taking oral corticosteroids for periods of more than three weeks should receive a steroid treatment card, or those receiving more than four short oral courses per year.

2. A steroid EMERGENCY card

Is a prompt to help healthcare staff to identify appropriate patients and gives information on the emergency treatment to start if they are acutely ill, or experience trauma, surgery or other major stressors.

The steroid emergency card should be given to all patients with primary adrenal insufficiency and those who are steroid dependent (on a long-term oral steroid).

Cards are available through community pharmacies or The card can be downloaded from the Society for Endocrinology adrenal crisis webpage.

Further information is available HERE

SGLT2 inhibitors: Serious side effects

February 2019 - SGLT-2 inhibitors are medicines that lower blood sugar by increasing the amount of glucose excreted in the urine. SGLT-2 Inhibitors are used in diabetes and also have benefits in kidney disease heart failure.

They include:

empagliflozin (Jardiance®)

canagliflozin (lnvokana®)

dapagliflozin (Forxiga®)

ertugliflozin (Steglatro®).

If you take one of these medications you should be aware of the potential side effects as, if they are not identified early, they can serious problems. As with all medication please read any information that accompanies the medication carefully. Please ask your Pharmacist, diabetic nurse or GP if you have any questions. The major side effects include:

Diabetic ketoacidosis

Sympoms include: Nausea, vomiting, fast breathing, abdominal pains, unusual drowsiness, or fever.

Fournier’s gangrene

An extremely rare side effect affecting about 1.6 out of 100,000 people

Symptoms include: Severe pain, tenderness, redness, or swelling in the genital or groin area accompanied by fever or malaise.

If you have any of these symptoms, please contact a medical professional, such as a doctor or nurse immediately, even if your blood sugars are near normal.

If your GP practice is closed, please call the NHS 111 service, by dialling 111, for more advice. Tell them that you are worried about one of the conditions above.

Stop this medication until you have further medical advice.

Full updates can be found HERE

Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use

November 2018 - Studies have shown a dose-dependent increased risk of non-melanoma skin cancer with exposure to increasing cumulative doses of Hydrochlorothiazide (contained in some combination products used for high blood pressure). Patients taking Hydrochlorothiazide should:

Regularly check for and report any new or changed skin lesions or moles
Limit their exposure to sunlight and UV rays and use adequate protection when exposed to sunlight and UV rays to minimise the risk of skin cancer
Make an appointment to discuss alternative options to the use of hydrochlorothiazide if you would like to and particularly if you have had a previous skin cancer.

Further information at: https://www.gov.uk/drug-safety-update/hydrochlorothiazide-risk-of-non-melanoma-skin-cancer-particularly-in-long-term-use