NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

ADTC decisions and other updates

 

ADTC decisions are here including:

The following medicines were added to the Adult Total Formulary:

  • Canagliflozin tablets (Invokana®) for use in adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control as add-on therapy, when these, together with diet and exercise, do not provide adequate glycaemic control. It is restricted to initiation by clinicians experienced in the management of diabetes.

 

  • Fluticasone furoate and vilanterol dry powder inhaler (Relvar Ellipta®) for the regular treatment of asthma in adults and adolescents aged 12 years and older where use of a combination medicinal product (long-acting beta2-agonist and inhaled corticosteroid) is appropriate in patients not adequately controlled with inhaled corticosteroids and 'as needed' inhaled short-acting beta2-agonists is included in the GGC Adult Formulary for the indication in question. Prescribing note: Fluticasone furoate is a high-potency inhaled steroid (with a dose of 92micrograms once daily broadly equivalent to 250micrograms twice daily of fluticasone propionate). When used for asthma, due consideration for the likelihood of step-down should be given prior to initiation as there are no available step-down options containing a dose lower than 92 microgram of fluticasone furoate.

 

Other Formulary decisions 

  • Diprobase® cream for the use as an emollient for dry skin conditions has been moved to the Total Formulary. Zerobase® Cream is the nearest Preferred List option.

Non-medical update

  • Minor surgery or other invasive procedures for people taking novel oral anticoagulants (NOACs): dentists and others who perform minor procedures, eg administer joint injections have criteria to assess suitability for those patients taking warfarin. Recent information has been presented to the NMP podiatry forum on the relevance of concomitant treatment with NOACs. This covers issues such as timing of next dose, effect of renal impairment on timings. Specific advice for apixaban, dabigatran and rivaroxaban can be found on Staffnet.
  • The new absorbent dressing of choice in all care settings in NHSGGC is now Premierpore instead of Mepore; with supplies available in wholesalers. Community pharmacists have been notified to run down current stock of Mepore.  

 

PostScript Extra: NSAIDs

There is a new PostScript Extra bulletin on Oral NSAIDs available here. This is an update to the previous version and is in line with the new anti-inflammatory guideline on nonsteroidal oral medicines which will shortly be posted on StaffNet. Naproxen and ibuprofen are the oral NSAIDs of choice taking into consideration the patient's GI and cardiovascular risks. The lowest effective dose should be used to control the patient's symptoms for the shortest duration possible.