Guidance to support primary care prescribers and pharmacists is available from the MLCSU Coronavirus guidance resource page. Links are provided to national resources and regional documents produced by MLCSU, RDTC, and SPS for use by Pan Mersey APC, LSCMMG, and GMMMG.
The list of resources will be updated as new material becomes available so please check back regularly for updates.
The Pan Mersey APC supports the use of COVID-specific guidance issued by NICE, and NHS England and NHS Improvement. During the COVID pandemic this will supersede any APC advice. In the absence of any COVID-specific advice then the usual Pan Mersey guidance and RAG rating will still apply unless otherwise indicated.
The Medicines Safety Assurance Tool (MSAT) is provided as a PDF document for reference. To request the spreadsheet solution of this safety tool, or for more information about this tool, to make a comment, or share a safety issue please contact email@example.com.
The MSAT was developed to improve the management of medicines related risk to patients. It is intended to provide commissioners with a systematic way of identifying and analysing emerging medicines safety issues and engage with providers to reduce medicines related harm.
Advice for healthcare professionals:
- Ensure the patient or carer, or both, are trained and understand optimal use of their adrenaline auto injector device.
- Advise the patient or carer, or both, to carry two adrenaline auto injectors at all times.
Codeine is contraindicated in all children aged 0-18 years who undergo tonsillectomy or adenoidectomy (or both) for obstructive sleep apnoea. Codeine is restricted to children over 12 years of age and only if the benefit outweighs the risks.
Domperidone is restricted to short term use in the relief of nausea and vomiting. The maximum recommended dose is 30 milligrams daily for one week. Contraindications include cardiac disorders, hepatic impairment, and concomitant QT prolonging or CYP3A4 inhibiting drugs.
The Pan Mersey Area Prescribing Committee recommends:
- All specialities, including haematology, should prescribe the methotrexate dose in multiples of 2.5mg tablets and the total dose in milligrams must also be included. For example, “Three 2.5mg tablets (7.5 milligrams)”;
- Methotrexate 10mg tablets MUST NOT be prescribed or supplied;
- Prescription and the dispensing label must clearly show the dose in milligram and the number of tablets to be taken and the frequency as “ONCE a week on the same day each week”;
- prescribing of methotrexate with co-trimoxazole or trimethoprim is an ABSOLUTE CONTRAINDICATION and MUST NOT occur under any circumstances*. This contraindication applies to people that have recently taken methotrexate.
The Pan Mersey Area Prescribing Committee recommends that ALL clinicians have a responsibility in ensuring that Drugs Prescribed Elsewhere are updated in the patients’ electronic medical records in order to ensure the accuracy of the Summary Care Record.
- Licensed use of valproate medicines in girls and women of childbearing potential requires a Pregnancy Prevention Programme to be in place.
- Valproate treatment must be started and supervised by an experienced specialist.
- Fulfilment of the conditions of the Pregnancy Prevention Programme must be checked at each point of prescribing and dispensing.