The evidence to support the use of antioxidant vitamins to reduce the progression of age related macular degeneration is limited. This bulletin reviews the evidence available and supports reviewing and stopping treatment with antioxidant vitamins.
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This bulletin discusses the use of co-proxamol and supports reviewing and discontinuing prescribing in patients still taking this unlicensed medicine.
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These resources support review of patients prescribed dosulepin with a view to switching to a safer agent.
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This bulletin supports the review of doxazosin MR prescribing and supports a switch to the immediate release formulation in line with the NHS England "Items which should not routinely be prescribed in primary care" guidance.
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Immediate release fentanyl has a NICE do not do as a first line treatment for breakthrough pain. This bulletin will focus on fentanyl immediate-release formulations.
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There is limited evidence to support the use of glucosamine and chondroitin products and they are listed as a NICE do not do. This bulletin reviews the use of glucosamine (with or without chondroitin) preparations.
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Herbal remedies
The MHRA allows herbal products to be marketed for minor health conditions that don’t require medical supervision, upon receipt of a Traditional Herbal Registration (THR). Claims to treat major health conditions are not allowed under a THR and would need a marketing authorisation. Under a THR there is no requirement to prove scientifically that a product works, the registration is based on longstanding use of the product. These products should be purchased as part of self care.
Homeopathic remedies
In 2010, a report by the House of Commons Science and Technology Committee found that the use of homeopathy was not evidence based and any benefits to patients was down to placebo effect.
This bulletin looks at lidocaine plasters and provides the rationale for not initiating lidocaine plasters in new patients, and for current patients to be considered for discontinuation of their prescription for lidocaine plasters.
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This bulletin has been updated to reflect the latest national guidance on liothyronine and it's place in therapy.
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This bulletin focuses on omega-3 fatty acids and provides the rationale for therapy to be stopped or for patients to be switched to alternative agents and for new patients not to be started on omega-3 fatty acids.
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This bulletin and resources provide further information on the evidence base for for using oxycodone/naloxone prolonged release tablets, the rationale to stop treatment and also suggests alternative treatment options.
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This bulletin was originally developed in May 2018, however as the price of perindopril erbumine was higher than perindopril arginine it was not published. The prices and references have been updated in this resource and it has been published for those commissioners who still wish to review prescribing.
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This resource covers rubefacients and other miscellaneous topical analgesics and provides support for reviewing prescribing of these products in line with the NHS England low priority prescribing guidance.
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Tadalafil once daily
Once daily tadalafil is not a cost effective treatment option. Currently on demand sildenafil is the preferred option.
This bulletin focuses on Tramacet® (paracetamol 325mg/tramadol 37.5mg) and provides the rationale for new patients to be initiated on paracetamol or paracetamol with codeine.
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Travel vaccines
This bulletin and supporting resources will support CCGs wishing to review their prescribing policies on travel vaccines. It identifies vaccines that should not be prescribed on the NHS for travel.
Trimipramine is a tricyclic antidepressant (TCA) that has been subject to significant price increases. This bulletin reviews the use of trimipramine with resources to support stopping or switching treatment in depression in adults.
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