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MHRA website has moved

29th January 2015

The UK Medicines and Healthcare products Regulatory Agency website has moved to become part of the UK government website

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Patient Safety Alert for LMWH

20th January 2015

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 and 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.

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Oral diclofenac restricted to a POM

15th January 2015

As of 15th January 2015, oral diclofenac is available only as a Prescription Only Medicine (POM) in the UK. All unexpired stock of products previously designated as Pharmacy medicines (P) have been recalled by the MHRA. 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 to determine if it is suitable for them and therefore products containing oral diclofenac no longer meet the requirements for supply with legal status ‘P’. Topical formulations containing diclofenac will continue to be available without a prescription.

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Levinan survey winners

13th January 2015

Many thanks to those members who responded to our request to complete the recent Levinan survey on By doing so you are helping to support our work.

We are delighted to announce the overall winner who will receive the ipad Air is:
Dr Katherine Oakley, St Helena Hospice, Colchester, Essex.

In addition the five winners to receive 12month’s subscription to the on-line Palliative Care Formulary are:
Dr Margriet Mulder, Overgate Hospice, Elland, Halifax.
Dr Katie Emmitt, University Hospital Lewisham, London.
Dr Michael Dunlop, Eden Valley Hospice, Carlisle, Cumbria.
Jaquie Hanley, Pharmacist, Antrim Area Hospital, Antrim.
Dr Clare White, Northern Ireland Hospice, Belfast, Antrim.

All the winners have been informed. Congratulations and thank you for your support.

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Metformin changes

7th January 2015

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 been updated.

In addition Glucophage oral powder sachets have now been discontinued.

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APPM Master Formulary 2015 3rd edition now available

6th January 2015

The 3rd edition of the Association for Paediatric Palliative Medicine (APPM) Master Formulary is now available and can be downloaded from the APPM website link below.

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Patient Safety Alert for potassium permanganate

6th January 2015

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.

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