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BNF provides advice on the differences between oral mesalazine products

The British National Formulary has updated its information on mesalazine oral preparations, which are used to treat mild to moderate ulcerative colitis, according to its latest newsletter (April 2014).

Colon

Source: Decade3d / Dreamstime.com

Patients who are switched between different oral mesalazine products are advised to report any changes in their symptoms

The BNF says that while there is no evidence that any one preparation is more effective than another, the delivery characteristics may vary, so patients who have to be switched to a different brand should be advised to report any changes in their symptoms. Oral mesalazine products, listed in BNF 67, include Asacol, Ipocol, Mezavant, Octasa, Pentasa, Salofalk.

The BNF and BNF for Children have also updated the recommended oral doses of amoxicillin and ampicillin to reflect concerns about variations in prescribing.

The changes have been made following research published recently in the British Journal of General Practice, which revealed that most children aged under one year were being prescribed twice the recommended dose of amoxicillin, and 40 per cent of 6-12 year olds and 70 per cent of 12-18 years old were being significantly under-dosed. This is thought to be due to GPs using age rather than weight when calculating dosages.

Other significant changes include:

  • The removal of anti-epilepsy preparations Epanutin capsules and Mysoline tablets due to the manufacturer replacing them with identical generic versions of phenytoin and primidone, respectively.
  • A warning for prescribers to specify the brand of adrenaline auto-injector to be dispensed following the addition of Emerade, which has a different injection technique to other products.
  • A reminder to assess patients for both active and inactive tuberculosis before and during treatment with infliximab or other cytokine modulators, and to advise patients to seek medical help if they develop TB-like symptoms such as persistent cough, fever or weight loss.
  • A revision of the dose of naloxone used for acute opioid overdosage in both adults and children.
  • A warning that phosphate-containing eye drops can cause corneal calcification in patients with pre-existing significant corneal damage.

In addition, several new products have been introduced:

  • Sofosbuvir for the treatment of chronic hepatitis C of certain genotypes (in combination only). The non-interferon treatment was launched earlier this year, but its NHS funding is unclear.
  • Dimethyl fumarate and teriflunomide for the treatment of relapsing-remitting multiple sclerosis. The National Institute for Health and Care Excellence is currently appraising dimethyl fumarate for use in the NHS; in a draft appraisal issued in February 2014, NICE said it was leaning towards not approving the medicine. In contrast, NICE recommended the use of teriflunomide in January 2014.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11137253

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