netFormulary NHS
Guildford And Waverley Joint Formulary
Guildford And Waverley CCG
Royal Surrey County Hospital NHS Foundation Trust
News Title

BNF updates  June, 2019

Two new drug monographs have been added to the BNF in the last month: prasterone and doravirine. One new drug monograph has been added to the BNFC in the last month: mepolizumab. 
• Dose changes for atovaquone with proguanil hydrochloride to both the BNF and BNFC and to caffeine citrate in the BNFC.
• MHRA advice including restrictions and precautions for use of fluoroquinolone antibiotics and yellow fever vaccine fatal adverse reactions: extreme caution needed in those who are immunocompromised or aged 60 years and older.
• Updated guidance in-line with Public Health England recommendations including influenza vaccine and malaria prophylaxis. 


RSCH memo: Shortage of licensed liquid phenytoin  June, 2019

Please be aware there is a national shortage of licensed liquid phenytoin.

We have managed to source an unlicensed import from the US. Given the narrow pharmacokinetics of phenytoin please be aware when switching brands in patients who are firmly established on one brand of phenytoin liquid (usually the Epanutin brand in the UK) there may be a change in plasma levels when switching to the unlicensed product.

Please monitor patients for signs of altered seizure control and consider plasma levels if this is an issue. The product does not come with it's own patient information leaflet therefore pharmacy will supply a generic leaflet about phenytoin the drug from a UK source.  Contact your ward pharmacist if you have any concerns.


Update:  April, 2019 Manufacture of all strengths of fluphenazine decanoate (Modecate®) has ceased.  Prescribers should complete arrangements to transfer patients to therapeutic alternatives under medical supervision.  Some stock is still available to allow smooth transition to the alternative therapy. (expires August 2019 for 25mg/ml and August 2020 for 100mg/ml)