BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

July 25 2018 Switching to sulfonylureas in type 2 diabetes has been linked with an increased risk...

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DOACs associated with reduced risk of major bleeding compared to warfarin

July 11 2018 Direct oral anticoagulants (DOACs) have been associated with reduced risks of major...

Recorded penicillin allergy associated with increased risk of MRSA and C difficile

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Syphilis and gonorrhoea diagnoses see significant increase

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Anticholinergics linked to increased risk of dementia

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  • BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

    BMJ: ‘Adding a sulfonylurea to metformin looks safer than switching to one’

    Wednesday, 25 July 2018 13:55
  • DOACs associated with reduced risk of major bleeding compared to warfarin

    DOACs associated with reduced risk of major bleeding compared to warfarin

    Wednesday, 11 July 2018 13:11
  • Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Recorded penicillin allergy associated with increased risk of MRSA and C difficile

    Tuesday, 03 July 2018 16:42
  • Syphilis and gonorrhoea diagnoses see significant increase

    Syphilis and gonorrhoea diagnoses see significant increase

    Monday, 11 June 2018 14:16
  • Anticholinergics linked to increased risk of dementia

    Anticholinergics linked to increased risk of dementia

    Monday, 30 April 2018 12:08

Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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a alert imageOctober 31 2017

The medicines regulator has issued four drug safety updates (DRU) relating to gabapentin methylprednisolone clozapine isotretinoin.

The MHRA’s warning on gabapentin says the people taking the drug, used in epilepsy and peripheral neuropathic pain, have “a rare risk of severe respiratory depression even without concomitant opioid medicines.” Dose adjustments may be necessary in a number of patient groups: those with compromised respiratory function; respiratory or neurological disease; renal impairment; concomitant use of central nervous system (CNS) depressants; and the elderly.

The warning around methylprednisolone relates to Solu-Medrone 40mg injection. This strength uses lactose produced from cows’ milk as an excipient and may contain trace amounts of milk proteins.

“Do not use injectable methylprednisolone medicines that contain lactose in patients with a known or suspected allergy to cows’ milk,” says the DSU. “If a patient’s symptoms worsen or any new allergic symptoms occur, allergic reaction to cows’ milk proteins should be suspected; stop administration of the product and treat the patient’s condition accordingly.”

Constipation occurring with clozapine needs to be monitored, says the third DSU. The antipsychotic has been associated with varying degrees of impairment of intestinal peristalsis, ranging from “constipation, which is very common, to very rare intestinal obstruction, faecal impaction, and paralytic ileus.”

Particular care is needed in patients who taking other drugs known to cause constipation, in patients with a history of colonic disease or lower abdominal surgery, or in patients aged 60 years and older. Clozapine should not be used in patients with paralytic ileus.

Patients who develop constipation should report it immediately, and health professionals should “actively treat any constipation that occurs.”

The isotretinoin DSU advises that there have been some reports of sexual dysfunction, especially erectile dysfunction and loss of libido, in patients taking oral isotretinoin for severe acne. “The exact incidence of these adverse reactions is unknown but considering the number of patients in the UK taking the medicine, reports are understood to be rare,” says the MHRA.

For all drugs, the MHR is asking that any suspected adverse reactions be reported using eth Yellow Card scheme.

Links:
MHRA DSU on gabapentin           
MHRA DSU on methylprednisolone          
MHRA DSU on clozapine                 
MHRA DSU on isotretinoin             
Yellow Card scheme        

Clinical News

July 31 2018 General practices employing pharmacists are citing improved capacity to see patients and workload changes as the main benefits of the scheme.
July 25 2018 Switching to sulfonylureas in type 2 diabetes has been linked with an increased risk of complications compared with staying on metformin, a BMJ study has concluded. However, the study has...