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Written by admin on Wednesday 18th October 2017
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The high risks associated with exposure to valproate medicines during pregnancy remain a topical, high priority patient safety concern and we would like to highlight recent developments to help improve valproate medicines safety in your pharmacy.
The Company Chemists Association (CCA) has published its summary report “Valproate medicines safety in community pharmacy” following a practice-based audit it conducted between 2018 and 2019.
The report identifies the need for further action to improve pharmacy team awareness of the Pregnancy Prevention Programme (PPP) and its importance in valproate medicines safety. The report also makes recommendations for action by several organisations, including the Medicines and Healthcare products Regulatory Agency (MHRA) and manufacturers of valproate medicines, to support community pharmacies in improving valproate medicines safety. This includes working together with the MHRA Valproate Stakeholder Network and patient groups to facilitate sharing of patient safety updates, increasing awareness and understanding of the risks associated with valproate use during pregnancy across all healthcare settings.
The General Pharmaceutical Council (GPhC) aims to follow the CCA recommendations by seeking evidence, during inspections, that pharmacy teams are following the Pregnancy Prevention Programme (PPP) for valproate and documenting this as part of the pharmacy’s inspection report.
Key actions for pharmacists and pharmacy teams
To improve valproate medicines safety, pharmacists and pharmacy teams are strongly recommended to implement findings from the CCA audit as follows:
Recommendations from the report
Actions for pharmacy teams to implement recommendations made
Drug (pack size)
Alverine capsules 60mg (100)
Amiloride tablets 5mg (28)
Bumetanide tablets 1mg (28)
Cefalexin oral suspension 125mg/5ml (100ml)
Cefalexin oral suspension 250mg/5ml (100ml)
Co-careldopa tablets 25mg/100mg (100)
Cyclizine solution for injection ampoules 50mg/1ml (5)
Dexamfetamine oral solution 5mg/5ml sugar free (500ml)
Hydroxyzine tablets 25mg (28)
Indapamide tablets 2.5mg (28)
Irbesartan / Hydrochlorothiazide tablets 150mg/12.5mg (28) *NEW*
Irbesartan tablets 150mg (28)
Irbesartan tablets 300mg (28)
Irbesartan tablets 75mg (28)
Lamotrigine dispersible tablets sugar free 100mg (56)
Levetiracetam tablets 1g (60)
Meloxicam tablets 7.5mg (30)
Meloxicam tablets 15mg (30)
Memantine tablets 10mg (28)
Nefopam tablets 30mg (90)
Nifedipine capsules 5mg (90)
Nifedipine capsules 10mg (90)
Nitrofurantoin tablets 100mg (28)
Nizatidine capsules 150mg (30)
Orlistat capsules 120mg (84)
Oxytetracycline tablets 250mg (28)
Propranolol tablets 10mg (28)
Propranolol tablets 40mg (28)
Quinine sulfate tablets 300mg (28)
Ranitidine tablets 150mg (60)
Ranitidine tablets 300mg (30)
Venlafaxine tablets 75mg (56)
Following the recall of all strengths of Emerade® prefilled pen (on 28 November 2019) the Department of Health and Social Care (DHSC) has issued a supply disruption alert (SDA) providing advice for healthcare professionals, including pharmacists, to issue to patients/carers administering adrenaline auto-injectors (AAIs).
Pharmacists and pharmacy teams should be aware that:
The DHSC has issued detailed guidance which includes:
Options for patients requiring ongoing treatment
Patients with in-date Emerade® pens can continue use and a supply of alternative AAI brands (EpiPen®/Jext®) for patients with expired/used Emerade® pens
A reminder to healthcare professionals in all healthcare settings including community pharmacists that adrenaline ampoules should be stocked for use as part of an anaphylaxis kit, AAIs should be reserved for supply to patients
A reminder for patients/carers on appropriate use of AAIs, including storage, training and the need to carry two in-date AAIs at all times
The extension of expiry dates for certain batches of EpiPen® (300 micrograms) and Jext® (150 micrograms; 300 micrograms)
The prescription validation process for the EpiPen® brand and restrictions for community pharmacies ordering Jext®
It may be convenient to retain a hard copy of the SDA for pharmacists to use in the dispensary of busy pharmacies. It can aid discussions with patients/carers and prescribers for pharmacies dispensing regular prescriptions for Emerade® pens.…
The Department of Health & Social Care (DHSC) has issued a Central Medical Officer (CMO) alert, “Influenza Season 2019/20: Use of Antiviral Medicines”, stating that antiviral medicines can now be prescribed by GPs and other primary care prescribers on NHS prescriptions. This recommendation has been made in response to surveillance data showing an increase in influenza cases and is in-line with National Institute for Health and Care Excellence (NICE) guidance for the treatment and prophylaxis of influenza.
Healthcare professionals including pharmacists can refer to the “for further information regarding patient eligibility for receiving oseltamivir (Tamiflu®) or zanamivir (Relenza®) on the NHS. This includes patients in clinical at-risk groups or those at risk of complications or severe illness from untreated influenza.
Advice for pharmacists and pharmacy teams
Read the CMO alert for details on prescribing antiviral medicines for specific age groups and those unable to swallow capsules
Ensure antiviral prescriptions are dispensed promptly to avoid delaying treatment
Ensure FP10 prescriptions are endorsed with ‘SLS’ from the prescriber in order for it to be passed for payment – prescriptions for antivirals oseltamivir (Tamiflu®) or zanamivir (Relenza®) need to be in accordance with Schedule 2 (the Selected List Scheme (SLS)) to the National Health Service (General Medical Services Contracts) (Prescription of drugs etc) Regulations 2004)
Only order antiviral medicines as needed to fulfil prescriptions – do not over order
Ensure appropriate infection control measures are in place – refer to the NPA standard operating procedures (SOPs) for infection control and hand hygiene
For further information on this or any other query, please contact the NPA Pharmacy Services team on 01727 891 800 or email email@example.com.…
The Department of Health has recently announced amendments to The Misuse of Drugs Regulations (Northern Ireland) 2002 which came into force on 15 November 2019. The changes to the legislation affect supply of Controlled Drugs (CDs) in community pharmacy and are detailed fully in The Misuse of Drugs (Amendment) Regulations (Northern Ireland) 2019.
Community pharmacists and pharmacy teams should be aware of the following changes:
Independent prescribers (IPs) who are physiotherapists podiatrists are permitted to prescribe a limited range of CDs
The full list of CDs that physiotherapist and podiatrist IPs can prescribe is laid out in Regulation 6C
Healthcare professionals such as doctors, dentists, paramedics and vets must use the mandatory standardised requisition form, CDRF1, when requesting stock of Schedule 2 and 3 CDs to be used privately in their practice (i.e. non-Health Service purposes)
A template form is available from Medicines Governance Northern Ireland
The HS21S should still be used by GPs for obtaining stock of Schedule 2 and 3 CDs for Health Service purposes
There is a requirement for other permitted individuals to use the CDRF1 form when requesting stock of Schedule 2 and 3 CDs, these include the owner or master of a ship, persons in charge of a laboratory when transferring CDs between pharmacies that are separate legal entities
Please note – the CDRF1 form should be used when transferring CDs between pharmacies, including between pharmacies that are separate legal entities, however use of the form under these circumstances is not a legal requirement
Completed CDRF1 forms, excluding veterinary requisitions and those relating to inter-pharmacy stock transfers, must be submitted to the Business Services Organisation (BSO) as part of the standard monthly submissions
Section O of the HS30 must be completed and this will provide an audit trail of CDs supplied through private requisitions
Northern Ireland Ambulance Service (NIAS) and Hospices are exempt from using this form and should use NIAS and hospice designated forms
Please note – the CDRF1 form should be used when transferring CDs between pharmacies, including between pharmacies that are separate legal entities, however this is not a legal requirement; in addition, when using the form under these circumstances, it does not need to be submitted to the BSO
In addition to the usual veterinary prescription requirements for Schedule 2 and 3 CDs, it isnow mandatory for the veterinary surgeon or veterinary practitioner issuing the prescription to include their Royal College of Veterinary Surgeons registration number on the prescription.…
Class 2 pharmacy level medicines recall – Emerade® solution for injection pre-filled syringe 150mcg, 300mcg and 500mcg – Action within 48 hours
28 November 2019
150mcg – PL 33616/0013
300mcg – PL 33616/0014
500mcg – PL 33616/0015
Emerade® solution for injection pre-filled syringe 150mcg, 300mcg and 500mcg.
Manufactured by Pharmaswiss Česka republika s.r.o. (an affiliate of Bausch & Lomb UK Limited)
A Class 2 pharmacy level medicines recall has been issued by the Medicines & Healthcare products Regulatory Agency (MHRA) for all unexpired batches of all strengths of Emerade® solution for injection pre-filled syringe manufactured by Pharmaswiss Česka republika s.r.o. (an affiliate of Bausch & Lomb UK Limited).
Further information can be found on the MHRA section on the GOV.UK website.
Produced by the NPA Pharmacy Services team November 2019.…