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DH Consultation: Governance arrangements for controlled drugs

28th September 2012

The Department of Health (DH) is consulting on proposed changes to the governance arrangements for controlled drugs in England and Scotland, including the role and functions of Controlled Drugs Accountable Officers (CDAOs). 

The significant structural changes introduced by the Health and Social Care Act 2012 will have an impact on the overall governance of controlled drugs and the role and functions of primary care trust CDAOs. Consequently, the Controlled Drugs (Supervision of Management and Use) Regulations 2006 require revision. 

The consultation and supporting documentation can be downloaded from the website link below. The consultation ends on 15 November 2012.

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Paracetamol overdose: new guidance on treatment

26th September 2012

New simplified guidance on the treatment of acute paracetamol overdose with acetylcysteine is now in place following an evidence-based review by the Commission on Human Medicines (CHM). Full details can be found in the MHRA September 2012 Drug Safety Update.

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BNFC now available as a free app

25th September 2012

Health professionals can now access the British National Formulary for children (BNFC) from a smartphone or tablet via a new application (app) from the National Institute for Health and Clinical Excellence (NICE). This follows the recent launch of the BNF app. The apps require an NHS Athens username and password and can be run without an internet connection once they have been downloaded.

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Batch recall of Lyrica 50mg capsules (Kosei Pharma)

25th September 2012

A company-led recall of a batch of Lyrica (pregabalin) hard capsules 50mg (parallel distributed in the UK by Kosei Pharma Limited) has been issued, as the label applied by the parallel distributor states the strength as 25mg instead of 50mg. It is understood that a very small number of units have been distributed. The affected batch number is 0605032P/2 (first distributed 7th September 2012; expiry date February 2015). For further information contact Kosei Pharma UK Customer Services (01753 569528).

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Ketamine injection supply problems

21st September 2012

Pfizer UK has confirmed that there is a supply problem with ketamine (Ketalar) 10mg/mL and 100mg/mL injection. All orders for these products are now being re-directed to a Pfizer central ordering point (0845 608866), to allow close monitoring of the stock situation. It is anticipated that the 100mg/mL injection will run out completely in the next week and will not be available until November 2014. Pfizer has stated that this situation has occurred due to a transfer of manufacturing site beyond their control. More ketamine 10mg/mL injection are being manufactured as an interim measure. The stock situation of ketamine 50mg/mL is currently sufficient but is being monitored. For further details please contact Pfizer customer services (01304 606161).

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Oxycodone m/r generic launched in UK

21st September 2012

Oxycodone m/r generic launched in UK

Qdem Pharmaceuticals (Cambridge, UK) have launched generic oxycodone m/r (Longtec prolonged release) 5mg, 10mg, 20mg, 40mg and 80mg tablets. Supplies will come from Bard Pharmaceuticals, the production and supply chain business of Napp, and will be available through the usual wholesalers. The NHS cost and product range comparison with Oxycontin m/r (Napp) is: 

Longtec (Qdem)
Tablets m/r 5mg, 10mg, 20mg, 40mg and 80mg, 28 days @ 1 tablet b.d.= £21, £21, £42, £85, and £170 respectively. 

Oxycontin (Napp)
Tablets m/r 5mg, 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg and 120mg, 28 days @ 1 tablet b.d. = £25, £25, £37, £50, £75, £100, £150, £200 and £300 respectively. 

Note: The remains of the m/r tablet may appear in the patient’s faeces (‘ghost tablets’), as can also occur with Oxycontin and Targinact (oxycodone/naloxone combined m/r tablet). These are inert residues, and do not affect the efficacy of the products.

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Dexamethasone 4mg/mL injection supply

6th September 2012

There has been a temporary UK manufacturer’s supply problem with the MSD (Organon livery) dexamethasone base 4mg/mL injection. However the manufacturers have confirmed today (06-09-2012) that supplies are now available and no further shortages are anticipated.

Note: The alternative Hospira brand of dexamethasone injection available (dexamethasone phosphate 4mg/mL) contains dexamethasone base 3.3mg/mL. There is scope for confusion when switching to this preparation or when switching from PO to SC route.

For more details clarifying dexamethasone prescribing see the www.palliativedrugs.com factsheet below, produced in 2010 when the labeling and prescribing of dexamethasone injection was standardized to dexamethasone base by the MHRA.

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Fentanyl (transmucosal) therapeutic review

6th September 2012

A therapeutic review on transmucosal fentanyl has been published in the Journal of Pain and Symptom Management (JPSM):

Twycross R. et al (2012) Therapeutic Reviews: Fentanyl (transmucosal). Journal of Pain and Symptom Management. 44: 131-149.

This is the 10th article in the series; previous ones include Octreotide (July 2010), Propofol (September 2010), Psychostimulants (November 2010), Thalidomide (January 2011), Ketamine (March 2011), Antipsychotics (May 2011), Loperamide (August 2011), Anti-epileptics (November 2011) and Stimulant laxatives (February 2012). All are based on monographs featured in the Palliative Care Formulary. 

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