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Levomepromazine 25mg/mL injection shortage

17th April 2019

There is a shortage of levomepromazine 25mg/mL injection in the UK, with both the manufacturer (Sanofi) and the only other UK supplier (Wockhardt) out of stock. Further stock is not anticipated until the end of April 2019.

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CME T34 syringe pumps now require foam pads to be added to the battery compartment

3rd April 2019

All Caesarea Medical Electronics (CME) T34 Ambulatory syringe pumps now need a foam pad to be added to the battery compartment to ensure the battery rests securely against the contacts. Kits should be ordered from CME to do this.

This information is in the latest CME field safety notice (FSN2018-001_Updated) and follows the previous alerts in March and September 2018, highlighting the possible loss of function due to inadequate battery connection.

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Gabapentin and pregabalin are now controlled drugs

1st April 2019

Gabapentin and pregabalin were reclassified as Schedule 3 controlled drugs, on 1 April 2019, under the Misuse of Drugs Regulations 2001 (see our previous news item), with exemption from safe custody.

Full controlled drug prescription writing and requisition requirements for Schedule 3 controlled drugs are required for supply. However, gabapentin and pregabalin do not need to be stored in a separate locked controlled drug cabinet. Information and answers to frequently asked questions are available on the Royal Pharmaceutical Society support alert.

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MHRA new restrictions and precautions for fluoroquinolone antibiotics

26th March 2019

New restrictions and precautions for use of fluoroquinolone antibiotics (ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin) are being introduced following very rare reports of potentially irreversible undesirable effects affecting the musculoskeletal and nervous systems.

The following advice for healthcare professionals has been published:

  • systemic fluoroquinolones can very rarely cause long-lasting (up to months or years), disabling, and potentially irreversible undesirable effects, sometimes affecting multiple systems, organ classes, and senses
  • advise patients to stop treatment at the first signs of a serious undesirable effect, such as tendinitis or tendon rupture, muscle pain, muscle weakness, joint pain, joint swelling, peripheral neuropathy, and central nervous system effects, and to contact their doctor immediately for further advice
  • do not prescribe fluoroquinolones:
    • for non-severe or self-limiting infections, or non-bacterial conditions
    • for some mild to moderate infections (such as in acute exacerbation of chronic bronchitis and chronic obstructive pulmonary disease, see updated SPC indications) unless other antibiotics that are commonly recommended for these infections are considered inappropriate
  • ciprofloxacin or levofloxacin should no longer be prescribed for uncomplicated cystitis unless other antibiotics that are commonly recommended are considered inappropriate (see updated SPC indications)
  • avoid use in patients who have previously had serious adverse reactions with a quinolone or fluoroquinolone antibiotic
  • prescribe with special caution for people > 60 years and for those with renal impairment or solid-organ transplants because they are at a higher risk of tendon injury
  • avoid use of a corticosteroid with a fluoroquinolone since coadministration could exacerbate fluoroquinolone-induced tendinitis and tendon rupture
  • report suspected undesirable effects to fluoroquinolone antibiotics via the MHRA yellow card scheme.

MHRA Drug safety update 

Advice sheet for patients