Medicine Recommendations

Hypersalivation

The colour classification was determined as part of the collaborative work between LCFT and Medicines Management leads. Local pathways and patient safety were taken into consideration.

Respiratory tract secretions in the last days of life

Treatment of post menopausal osteoporosis

MHRA Drug Safety Update - Bisphosphonates: very rare reports of osteonecrosis of the external auditory canal

MHRA Drug Safety Update - Bisphosphonates: atypical femoral fractures

Postmenopausal osteoporosis

MHRA Drug Safety Update - Bisphosphonates: very rare reports of osteonecrosis of the external auditory canal

MHRA Drug Safety Update - Bisphosphonates: atypical femoral fractures

adjuvant treatment of early breast cancer in postmenopausal women with a high risk of recurrence (unlicensed indication)

Acute Gout (as per LSCMMG Guidelines)

MHRA Drug Safety Update - High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk

MHRA Drug Safety Update - Non-steroidal anti-inflammatory drugs (NSAIDs): reminder on renal failure and impairment

MHRA Drug Safety Update - Non-steroidal anti-inflammatory drugs (NSAIDs): cardiovascular risks

MHRA Drug Safety Update - NSAIDs and coxibs: balancing of cardiovascular and gastrointestinal risks

Pain

MHRA Drug Safety Update - High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk

MHRA Drug Safety Update - Non-steroidal anti-inflammatory drugs (NSAIDs): reminder on renal failure and impairment

MHRA Drug Safety Update - Non-steroidal anti-inflammatory drugs (NSAIDs): cardiovascular risks

MHRA Drug Safety Update - NSAIDs and coxibs: balancing of cardiovascular and gastrointestinal risks

Pain: Anti-inflammatory

Reducing the risk of cardiovascular events in people with raised triglycerides - NICE TA805

NICE TA805 - Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides

For adult patients treated with Pradaxa (dabigatran etexilate) when rapid reversal of its anticoagulant effects is required for emergency surgery/urgent procedures or in life-threatening or uncontrolled bleeding

Raynauds

Depressive illness

Treatment of Actinic Keratosis

Treatment of small superficial basal-cell carcinomas in adults

For treating primary hypercholesterolaemia or mixed dyslipidaemia (NICE TA733)

Please refer to the LSCMMG inclisiran position statement for further information on use within Lancashire and South Cumbria

Rheumatoid arthritis (LSCMMG pathway)

Psoriatic arthritis (NICE TA199)

NICE TA199 - Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis

Second line in psoriatic arthritis (PsA) following discontinuation of first anti-TNF due to an adverse event or primary or secondary inefficacy .

Use in high risk patients for prevention of recurrence or upon recurrence of Crohn's Disease following surgery.

Juvenile Idiopathic Arthritis (JIA) in Adult Patients