Selected items from the News and Latest Additions sections of www.palliativedrugs.com, the world’s leading palliative care website.
Safety alerts
Patient Safety Alert for Potassium Permanganate
NHS England has issued a patient safety alert (NHS/PSA/W/2014/18) warning of the risk of death or serious harm from accidental ingestion of potassium permanganate products. Potassium permanganate products are for external use only and are available as a solution for further dilution and as a tablet preparation, which is dissolved in water. For more information, click here.
Patient Safety Alert for LMWH
NHS England has issued a patient safety alert (NHS/PSA/W/2015/001) warning of the risk of harm from using low molecular weight heparin (LMWH) when contra-indicated, and highlighting the importance of assessing each patient individually as to whether the benefits of using LMWHs outweigh the risks. This follows several reports of harm or death. Contra-indications include but are not limited to:
- active bleeding
- acquired bleeding disorder, e.g. acute liver failure
- concurrent use of anticoagulants known to increase risk of bleeding
- concurrent use of antiplatelets and other interacting medicines
- lumbar puncture/epidural/spinal anaesthesia within the previous four hours, or expected within the next 12 hours.
For more information, click here.
Hot topics
MHRA Website has Moved
The UK Medicines and Healthcare products Regulatory Agency (MHRA) website has moved to become part of the UK government website https://www.gov.uk. For more information, click here.
Drug updates
Oral Diclofenac Restricted to a POM
As of 15th January 2015, oral diclofenac is available only as a Prescription Only Medicine (POM) in the UK. In 2013 a Europe wide review concluded that systemic diclofenac is associated with a small increased risk of arterial thromboembolic events, similar to that of COX-2 inhibitors. Following a public consultation (see our news item 8th August 2013), the UK Commission on Human Medicines (CHM) has concluded that patients need to have a medical assessment before taking oral diclofenac. Topical formulations containing diclofenac will continue to be available without a prescription. For more information, click here.
Metformin Changes
Detailed dosing recommendations for the use of metformin in renal impairment have been added to the SPCs for Glucophage 500mg and 850mg tablets (Merck Serono). The maximum daily dose in Stage 3a moderate renal impairment is 1000mg, given as 2 divided doses. It is contra-indicated in patients with creatinine clearance <45mL/min. Note the SPCs for Glucophage SR and generic formulations of metformin have not yet been updated. In addition Glucophage oral powder sachets have now been discontinued. For the Glucophage tablet SPC, click here.
Prepared by Sarah Charlesworth and Andrew Wilcock.