Evidence of harm from fake or illicit benzodiazepines
The
Department of Health has issued a letter (attached) highlighting the availability of, and harm from,
illicit drugs sold as benzodiazepines – particularly when used in
conjunction with alcohol and with drugs with a respiratory depressant effect
including gabapentinoids and opioids.
Summary
This letter is directed at all
those who are in contact with people who
use drugs and is aimed at increasing awareness to the possibility of overdose
arising from illicit drugs sold as benzodiazepines, helping with the
recognition of the possible symptoms of overdose, and advising on how to
respond appropriately.
The letter includes the
following sections:
Information
for professionals on illicit drugs sold as benzodiazepines
Harm
reduction advice and information for wider circulation
Actions advised
Other
sources of information
Reporting intelligence
Action
Contractors should:
(a) Make their dispensing teams aware of the content of this letter.
CPNI colleagues will continue to support
contractors on these matters.
Kind regards
Mike
Sent
on behalf of Prof Mike Mawhinney | Head of Regulatory Affairs
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Dear Colleague,
Updated HSCB Interim Protocol for
COVID-19 Testing – Version 6.1 issued 23rd July 2020
HSCB has updated and released
version 6.1 of the COVID-19 Interim Protocol for Testing.
A number of aspects have been
updated within this version of the protocol and they are easily identifiable.
Please bring this updated v6.1 interim testing protocol to the attention of
all your Pharmacy teams.
You will note page 17 includes a
new section on antibody testing.As stated, there is considerable
uncertainty about the significance of a positive test result for antibodies.
While it means than an individual has had COVID-19 at some time in the past
this does not indicate that the individual cannot be re-infected with the
virus, or pass it on to others, or have protective immunity. In view of
this uncertainty, the approach to antibody testing over the next few months
will be to offer testing to health and care workers in hospital and community
settings, including independent contractors as part of a seroprevalence study.
CPNI is currently working with HSCB colleagues to develop operational
arrangements which will provide access to antibody testing for community
pharmacy teams.
Version 6.1 replaces version 5.1
issued by HSCB on 23rd May and contained in CPNI Contractor Update #
99.
Please do not hesitate to contact
your local HSCB office should you require any additional information.
Yours sincerely
SENT
FOR AND BEHALF OF GERARD GREENE | Chief Executive
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Dear Colleague,
A newly published survey by epilepsy charities
Epilepsy Action, Epilepsy Society and Young Epilepsy found one in ten
(11%) women who are currently taking the epilepsy medicine valproate are
unaware of the possible risk of birth defects if taken in pregnancy.
Furthermore, one in five (18%) don’t know that, when taken in pregnancy, the
medicine could also cause learning and developmental delays in children.
Under the current regulations, valproate must
no longer be used for women and girls who are able to become pregnant unless
there is a Pregnancy Prevention Plan (PPP) in place. The PPP, mandatory at
prescription, is an intervention from the MHRA designed to make sure patients
are fully aware of the risks of valproate use in pregnancy and the need to
avoid becoming pregnant.
The survey found that many women with epilepsy
are still not receiving information from health professionals about the risks
of valproate, leaving their potential future children at risk of harm.
“Valproate dispensing from the pharmacist
Just under half of respondents (49%, 251/514) said they had had
no discussion with their pharmacist about the risks associated with taking
valproate during pregnancy. Only 14% (72/514) said they had this discussion
every time they collected a prescription.
29% (150/514) of respondents stated that when their valproate
was dispensed in a plain package, the box never had a sticker with the warning
pictogram. Only 60% (306/514) of respondents stated that a prescription in a
manufacturer’s packaging always included the warning pictogram.
Over half (51%, 261/514) of respondents said they had never
received the Patient Card from their pharmacist when receiving their
prescription”
PHARMACISTS are asked to take the following IMPORTANT ACTIONS:
Provide a Patient Card every time you dispense a valproate medicine to ALL female patients. Please also note that the outer boxes of valproate are being changed in order to include a removable patient card, to be detached and given to the female patient at the time of dispensation.
When dispensing any valproate preparation to female children, adolescents, women of childbearing potential, or pregnant women check that their prescriber has discussed the risks of exposure in pregnancy with them and they are aware of these and subsequently they are taking effective contraception unless already pregnant.
If the prescriber has not discussed the risks with the patient or the patient is not taking effective contraception, tell them to contact their GP or specialist for an urgent follow-up appointment.
Advise the patients not to stop valproate medication and to immediately contact their GP or specialist in case of suspected pregnancy.
Ask if they have received the Patient Guide and provide a copy if they have not received this or no longer have it in their possession.
Dispense valproate in the original package with the outer warning and avoid repacking. In the situations where this cannot be avoided, always provide a copy of the package leaflet, patient card, and add a warning sticker to the outer box.
To order new or further PPP materials, please contact Sanofi
medical information department on 0845 372 7101 or email UK-Medicalinformation@sanofi.com.
Please share this important information with all pharmacy staff.
Yours sincerely
SENT FOR AND BEHALF
OF GERARD GREENE | Chief Executive
Dear Contractor
Update: cannabis-based medicinal products
The
Department of Health has issued a letter summarising and updating information
in respect of cannabis-based medicinal products (attached). This letter is addressed mainly to
those who are in the position of deciding whether to prescribe cannabis-based medicinal
products.
Summary
Since 1
November 2018 specialist doctors on the Specialist Register of the General
Medical Council have been able to decide whether to prescribe cannabis-based
medicinal products where there is an unmet clinical need.
The letter highlights recent developments in this area and some new resources that have been developed to support the making of clinical decisions. The letter covers a number of areas including:
Re-scheduling
of Epidyolex® and insertion of a new definition under the Misuse of Drugs
Regulations (Northern Ireland) 2002;
NICE
Clinical Guidance and Technology Appraisals;
Refractory
Epilepsy Specialist Clinical Advisory Service (RESCAS);
Frequently
Asked Questions (FAQs).
Action
Contractors should:
(a) Be aware of the content of this letter for access where appropriate.
CPNI colleagues will continue to support
contractors on these matters.
Kind regards
Mike
Sent
on behalf of Prof Mike Mawhinney | Head of Regulatory Affairs
Download
Dear Contractor
Update to Serious Shortage Protocols: Fluoxetine 40mg Capsules
The
Department of Health has issued updated information (attached) on the Serious
Shortage Protocol (SSP) which was issued on 20 May 2020 in respect of
fluoxetine 40mg capsules.
Summary
The SSP was issued with an end date
of Monday 20 July 2020, but this has now been extended and the SSP will end on Monday
10 August 2020. Details
of the SSP are available on the BSO website and can be accessed via this link:
Brief their dispensing teams on the extension of the SSP.
CPNI colleagues will continue to support
contractors on these matters.
Kind regards
Mike
Sent
on behalf of Prof Mike Mawhinney | Head of Regulatory Affairs
Download
UPDATED SURVEY LINK
Dear Colleague,
We have received feedback from contractors that the previous
HSCB survey link was having technical issues. If you are having difficulties,
please use the following alternate survey link: https://www.surveymonkey.co.uk/r/65ZCGG7
Please note, the updated survey link requires the survey to be
completed in one go, information cannot be saved.
The closing date for completion of the survey is Friday 24th
July 2020.
If you are still having issues, please contact your local HSCB
office or the CPNI office.
Yours sincerely
SENT FOR AND BEHALF OF GERARD GREENE | Chief Executive
Also see CPNI COVID19 ContractorUpdate #114 RE: HSCB Survey Deadline *** Fri 24 Jul-20 *** sent 20 July 2020 @ 09:23
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