Version: 3 Date Approved: January 2013 Review Date: January 2015

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Version: 3 Date Approved: January 2013 Review Date: January 2015"

Transcription

1 SHARED CARE PROTOCOL AND INFORMATION FOR GPS Lithium for Treatment and prophylaxis of mania; bipolar disorder; augmentation therapy in treatment resistant depression AREAS OF RESPONSIBILITY FOR THE SHARING OF CARE This shared care agreement outlines suggested ways in which the responsibilities for managing the prescribing of Lithium can be shared between the specialist and general practitioner or non-medical prescriber in primary care (GP). GPs are invited to participate. If the GP is not confident to undertake these roles, then he or she is under no obligation to do so. In that case, the total clinical responsibility for the patient for the diagnosed condition remains with the specialist. If a specialist asks the GP to prescribe drugs for this treatment, the GP should reply to this request as soon as practicable. Sharing of care assumes communication between the specialist, GP and patient. The intention to share care should be explained to the patient by the doctor initiating treatment. It is important that patients are consulted about treatment and are in agreement with it. For patients detained under The Mental Health (Care and Treatment) (Scotland) Act 2003, lithium must be included in the T2 or T3 Treatment Plan. Patients with bipolar disorder or treatment resistant depression are under regular specialist follow-up. This provides an opportunity to discuss and to monitor drug therapy. The doctor who prescribes the medication legally assumes clinical responsibility for the drug and the consequences of its use. Lithium is a well-established treatment for mood disorders including bipolar disorder, mania and recurrent or resistant depression it has a narrow therapeutic window and monitoring of blood levels is essential for its safe use. National Patient Safety Agency (NPSA) Drug Name: Lithium Clinical Indications: Treatment and prophylaxis of mania; bipolar disorder; augmentation therapy in treatment resistant depression Version: 3 Date Approved: January 2013 Review Date: January 2015 In December 2009 the NPSA made the following recommendations in a Patient Safety Alert Patients prescribed lithium are monitored in accordance with NICE guidance on the management of bipolar disorder There are reliable systems to ensure blood test results are communicated between laboratories and prescribers At the start of lithium therapy and throughout their treatment patients receive appropriate ongoing verbal and written information and a record book to track lithium blood levels and relevant clinical tests. Record book available from Clinical Management, Stratheden Hospital ( ). Prescribers and pharmacists check that blood tests are monitored regularly and that it is safe to issue a repeat prescription and/or dispense the prescribed lithium Systems are in place to identify and deal with medicines that might adversely interact with lithium therapy.

2 RESPONSIBILITIES and ROLES Specialist responsibilities 1 Confirm diagnosis 2 Assessment of baseline mental state 3 Discuss the benefits and side effects of treatment with the patient and advise patient of signs of toxicity. 4 For patients detained under The Mental Health (Care and Treatment) (Scotland) Act 2003, ensure that lithium is included in the T2 or T3 Treatment Plan. 5 Undertake baseline investigations- renal function, thyroid function, calcium and baseline ECG if existing cardiac disease or risk factors 6 Ensure that a baseline weight is recorded 7 Consider any drug interactions 8 Consider any pre-existing conditions which require particular caution with lithium 9 Discuss the shared care arrangement with the patient. 10 Provide patient with Lithium Therapy NPSA booklet [Record book available from Clinical Management, Stratheden Hospital ( )] and complete initial details. 11 Initiate treatment with Lithium or advise GP on initiating treatment. Prescribe using brand name, usually Priadel. 12 Ensure that serum lithium monitoring is carried out during initial titration and after dose changes either in secondary care or by arrangement with the GP 13 Counsel female patients to take contraceptive precautions during treatment. Record in GP referral letter that contraceptive advice has been given 14 Ask the GP whether he or she is willing to participate in shared care. 15 Complete Shared Care Lithium Treatment Plan 16 Review the patient's condition and monitor compliance and response to treatment regularly where indicated. The need for continued lithium therapy should be assessed regularly and patients should be maintained on lithium after 3-5 years only if benefit persists. 17 Advise GP of the necessary ongoing monitoring and the frequency. 18 Monitor any other parameters considered necessary, or advise GP on which to monitor. 19 Communicate promptly with the GP when treatment is changed or needs to be changed by the GP, any results of the monitoring undertaken, and assessment of adverse events. 20 Have a mechanism in place to receive rapid referral of a patient from the GP in the event of deteriorating clinical condition. 21 Evaluate any adverse events reported by patient, carer or GP 22 Report adverse events to the MHRA via Yellow Card Scheme. 23 Ensure that clear backup arrangements exist for GPs to obtain advice and support. General Practitioner responsibilities 1 Reply to the request for shared care as soon as practicable. 2 Prescribe Lithium at the dose recommended. Prescribe using brand name, usually Priadel 3 Adjust the dose as advised by the specialist. 4 Consider any drug interactions 5 Monitor Lithium serum levels, calcium, renal and thyroid function as in monitoring section 6 Monitor weight/bmi 7 Update Shared Care Treatment Plan 8 Confirm patient has NPSA booklet and update information 9 Report to and seek advice from the specialist on any aspect of patient care that is of concern and may affect treatment. 10 Refer patient to specialist if his or her condition deteriorates. 11 Stop treatment on the advice of the specialist or immediately if an urgent need to stop treatment arises. 12 Report adverse events to the specialist and to the MHRA via the Yellow Card Scheme. Patient's role 1 Attend regular appointments for assessment and blood sampling 2 Report to the specialist or GP if he or she does not have a clear understanding of the treatment. 3 Share any concerns in relation to treatment. 4 Report any adverse effects to the specialist or GP. 5 Ensure hand-held record in NPSA booklet is regularly updated

3 BACK-UP ADVICE AND SUPPORT Sector Consultant Psychiatrist Pharmacy Services or local clinical pharmacist SUPPORTING INFORMATION Licensed indications (From SPC Priadel- indications for other products may vary) Management of acute manic or hypomanic episodes Management of episodes of recurrent depressive disorders where treatment with other antidepressants has been unsuccessful Prophylaxis against bipolar affective disorders Control of aggressive behaviour or intentional self-harm Dosage and Administration Lithium has a low therapeutic/toxic ratio and should be started at a low dose and titrated up to achieve therapeutic levels as indicated by serum lithium monitoring. The recommended therapeutic range is mmol/L ( mmol/L in elderly patients). Dosage must be individualised depending on serum lithium levels and clinical response. The dosage necessary to maintain serum lithium levels within the therapeutic range varies from patient to patient. The minimum effective dose should be sought and maintained. Contraindications and precautions for use Contraindications Hypersensitivity to lithium or to any of the excipients; Cardiac disease. Cardiac insufficiency. Severe renal impairment. Untreated hypothyroidism. Breast-feeding. Patients with low body sodium levels, including for example dehydrated patients or those on low sodium diets. Addison's disease. Brugada syndrome or family history of Brugada syndrome. See SPC or BNF for complete list of precautions Pregnancy Lithium therapy should not be used during pregnancy, especially during the first trimester, unless considered essential. Women of child-bearing potential should use effective contraceptive methods during treatment with lithium Women taking lithium who are planning a pregnancy or who become pregnant must be referred to psychiatric services for advice. Breastfeeding Lithium is excreted in breast milk with resultant risk of toxicity in the infant. Manufacturers advise to avoid. Withdrawal Unless due to serious adverse reaction, withdrawal should be gradual and take place under the supervision of a Consultant in Psychiatry. Abrupt discontinuation increases the risk of relapse. See BNF section 4.2.3

4 Side Effects See SPC or BNF for complete list of adverse effects Side effects may be short term and are usually dose dependent. They can often be prevented or relieved by a moderate reduction in dose. Type of adverse effect GI disturbances e.g. nausea, diarrhoea, dry mouth Weight gain Oedema Fine tremor Polyuria (frequent urination) Polydipsia (frequent thirst) Hypothyroidism Signs of toxicity: Blurred vision, muscle weakness, drowsiness, coarse tremor, dysarthria, ataxia, confusion, convulsions, nausea & vomiting, ECG changes. MONITORING Action to be taken Ensure patient aware of need for fluid replacement Monitor Advise to avoid crash diets & sugary drinks. Monitor may respond to dose reduction. Consider slight reduction in dose Advise re: fluid intake. May require investigation for diabetes insipidus if persistent Consider thyroid replacement if clinically indicated Stop lithium immediately, measure lithium, creatinine, urea and electrolytes. Refer to hospital if clinical condition warrants Serum Lithium monitoring Serum lithium must be monitored 5-7 days after initiation, then weekly until steady state is reached, then 3 monthly when stable (more frequently, typically 2 monthly in the elderly). More frequent monitoring is required following alteration of dosage; on development of intercurrent disease; in those with or at risk of cardiac, renal or thyroid disease; signs of manic or depressive relapse; following significant change in sodium or fluid intake; if an interacting drug is being taken or if signs of lithium toxicity occur. Lithium serum levels should be measured 12 hours after the previous dose. Patients taking lithium once daily at night should have the level measured in the morning 12 hours after the previous night time dose. Patients taking lithium twice daily should have the level measured in the morning 12 hours after the previous night time dose. The morning dose must be postponed until after the sample has been taken. Cardiac, renal, thyroid and calcium monitoring- minimum requirements Baseline ECG for those with existing cardiac disease or risk factors. Renal function- baseline and then every 6 months. Calcium- baseline and then every 6 months Thyroid function -TSH and T4 baseline and then every 6 months More frequent monitoring may be indicated in those with or at risk of cardiac, renal or thyroid disease. Weight should also be monitored Drug Interactions Refer to SPC or BNF appendix 1 for complete list Some medicines may result in increased lithium levels and risk of toxicity, e.g. diuretics (especially thiazides), NSAIDs, ACE inhibitors, angiotensin II receptor antagonists, SSRIs and other psychotropic medicines. Increased risk of ventricular arrhythmias with amiodaraone (avoid). Cost REFERENCES Priadel Tablets 200mg 100 tablets 2.30 Priadel Tablets 400mg 100 tablets 3.35 Priadel Liquid 150ml 5.61 BNF Edition 63 March 2012 NICE Clinical Guideline 38 Bipolar Disorder 2006 SIGN Guideline 82 Bipolar Affective Disorder 2005

5 ADDITIONAL INFORMATION Preparations are NOT Bioequivalent Two salts of lithium are available (lithium carbonate and lithium citrate) which contain different amounts of lithium (mmolli + ) and are not interchangeable. Lithium carbonate (tablets) 200mg lithium citrate (liquids) 509mg Lithium must always be prescribed by trade name Priadel tablets are the most frequently prescribed lithium preparation in Fife and Priadel liquid the most commonly prescribed liquid lithium preparation. *See Appendix 1- Equivalent doses of Priadel liquid and Priadel tablets. Alternative preparations Lithium preparations vary widely in bioavailability therefore any change of preparation (even those containing the same salt) requires the same precautions as initiation of treatment i.e. weekly monitoring. LITHIUM CARBONATE TABLETS Trade Name Tablet Strength Available Amount of Lithium (Li + ) Priadel 200mg m/r (scored) 400mg m/r (scored) 5.4mmol/200mg 10.8mmol/400mg Camcolit 250 Camcolit mg (scored) 400mg m/r (scored) 6.8mmol/250mg 10.8mmol/400mg Liskonum 450mg m/r (scored) 12.2mmol/450mg LITHIUM CITRATE LIQUID Trade Name Liquid Strength Available Amount of Lithium (Li + ) Priadel * 520mg/5ml 5.4mmol/5ml Li-liquid 509mg/5ml 5.4mmol/5ml Li-liquid 1018mg/5ml 10.8mmmol/5ml Dosing frequency depends on preparation prescribed Liquid preparations and Liskonum tablets should be prescribed twice daily Other lithium preparations are usually prescribed as a single dose at night. Interpretation of serum lithium level (Range: mmol/L, elderly mmol/L) Level Action to Be Taken < 0.5mmol/L & patient is well and pattern Do not alter dose. of levels has been low but within specified range for that patient. < 0.5mmol/L & patient unwell & pattern of Assess compliance, increase dose if appropriate, and recheck levels on lower end of specified range for level in 5 days. that patient. < 0.5mmol/L & is inconsistent with the Assess compliance, consider other factors e.g. drug interactions, trend. excess fluid intake, brand change, and recheck level. > 1.0mmol/L with no signs of toxicity. If there is an explanation for the high level e.g. dehydration, timing of level, interacting medicines, brand change, correct where possible and recheck level. > 1.0mmol/L with no signs of toxicity and Decrease dose, encourage fluids, recheck in 5 days. the trend is for high end of range. > 1.0mmol/L with no signs of toxicity and Recheck level, check e GFR, and urea, creatinine and no explanation for high level. electrolytes. If patient shows signs of toxicity Stop lithium immediately, measure lithium, egfr, creatinine, Blurred vision, muscle weakness, urea and electrolytes. drowsiness, coarse tremor, dysarthria, Refer to hospital if clinical condition warrants ataxia, confusion, convulsions, nausea & vomiting, ECG changes

6 Appendix 1 Equivalent doses of Priadel Liquid and Priadel Tablets All liquid lithium preparations contain Lithium Citrate and all tablet preparations contain Lithium Carbonate. These are not interchangeable. Priadel is the most frequently prescribed brand of lithium in Fife. Each 5ml of Priadel liquid contains 520mg of lithium citrate which is equivalent to 204mg of lithium carbonate. Priadel Tablets contain lithium carbonate. Confusion between Lithium Carbonate and Lithium Citrate is a common cause of error. Equivalent doses of Priadel tablets and liquid Priadel Tablets Priadel Liquid 200mg 5ml 400mg 10ml 600mg 15ml 800mg 20ml 1g 25ml 1.2g 30ml 1.4g 35ml Priadel liquid should be given in divided doses, ideally twice daily The following table shows what quantity of Priadel liquid should be prescribed if switching between Priadel l tablets and Priadel liquid. Priadel tablets Priadel liquid 200mg daily 2.5ml twice daily 400mg daily 5ml twice daily 600mg daily 7.5ml twice daily 800mg daily 10ml twice daily 1g daily 12.5ml twice daily 1.2g daily 15ml twice daily 1.4g daily 17.5ml twice daily All Lithium preparations must be prescribed by brand name (usually Priadel ) as bioavailability varies. Any change in formulation (e.g. tablets to liquid) or brand requires the same monitoring of lithium levels as initiation of treatment If there are any queries about changing between the different preparations of Priadel or any of the other lithium preparations please contact your local clinical pharmacist for advice or alternatively contact pharmacy services on

7 SHARED CARE LITHIUM TREATMENT PLAN PATIENT SPECIFIC DETAILS CONSULTANT To be completed at time of discharge/outpatient review and sent to GP NAME ADDRESS DOB/CHI Current indication: (e.g.bipolar prophylaxis / augmentation) Desired Therapeutic range: ( mmol/L, elderly mmol/L) Dosage Regime: Brand used: Last level/date: / Level next due: PHYSICAL & BLOOD MONITORING TO BE CARRIED OUT BY: Psychiatrist Lithium Clinic Day Care Unit GP Other Frequency of lithium monitoring (minimum 3 monthly/2 monthly in elderly) Completed by (sign & print name) MINIMUM MONITORING REQUIREMENTS FOR ESTABLISHED LITHIUM TREATMENT Date NB more frequent monitoring may be required if clinical indications arise and in higher risk patients, e.g. those on interacting drugs (see BNF), those with or at risk of renal / thyroid / cardiac disease. BASELINE ECG DONE? Yes/No/Not required LITHIUM minimum 3 monthly NB sample at approx. 12 hours post dose. Ensure time interval is same at each measurement, if varies, state clearly on form. RENAL AND THYROID FUNCTION CALCIUM 6 monthly 6 monthly PSYCHIATRIC REVIEW GP s should consider patients for formal review by psychiatrist after 2 5 years of lithium therapy to assess ongoing benefit.

8 Results Current dose regimen and Brand Date of next blood level Date of current blood level Serum Lithium Level (mmol/l) Renal function (egfr) Thyroid function Calcium Weight/ BMI Comments e.g. dose alteration, side effects, mood rating, non-compliance

SHARED CARE GUIDELINE FOR LITHIUM. 1. Aim/Purpose of this Guideline. 2. The Guidance

SHARED CARE GUIDELINE FOR LITHIUM. 1. Aim/Purpose of this Guideline. 2. The Guidance SHARED CARE GUIDELINE FOR LITHIUM 1. Aim/Purpose of this Guideline 1.1. This guideline applies to medical, nursing and pharmacy staff in the safe and appropriate prescription and administration of lithium.

More information

Monitoring of patients prescribed lithium

Monitoring of patients prescribed lithium POMH-UK Topic 7 Monitoring of patients prescribed lithium Please use the following to cite this report: Prescribing Observatory for Mental Health (2009). Topic 7 baseline report. Monitoring of patients

More information

Bournemouth, Dorset and Poole Prescribing Forum

Bournemouth, Dorset and Poole Prescribing Forum SHARED CARE GUIDELINES FOR PRESCRIBING OF METHYLPHENIDATE IN ATTENTION DEFICIT HYPERACTIVITY DISORDER IN CHILDREN INDICATION Methylphenidate is generally regarded as a first line choice of treatment for

More information

NHS Kent and Medway Medicines Management. Dronedarone (Multaq ) Shared Care Guideline For Prescribing

NHS Kent and Medway Medicines Management. Dronedarone (Multaq ) Shared Care Guideline For Prescribing NHS Kent and Medway Medicines Management Dronedarone (Multaq ) Shared Care Guideline For Prescribing Issue No: 2 Review Date (If Applicable): Accountable Officer: Heather Lucas Contact Details: 01233 618158

More information

SHARED CARE AGREEMENT: MELATONIN (CHILDREN)

SHARED CARE AGREEMENT: MELATONIN (CHILDREN) NB: This document should be read in conjunction with the current Summary of Product Characteristics (SPC) where appropriate. DRUG AND INDICATION: Generic drug name: Formulations: MELATONIN 3mg immediate

More information

PATIENT GROUP DIRECTIONS FOR SUPPLY OF VARENICLINE (CHAMPIX ) BY AUTHORISED COMMUNITY PHARMACISTS WORKING IN TAYSIDE

PATIENT GROUP DIRECTIONS FOR SUPPLY OF VARENICLINE (CHAMPIX ) BY AUTHORISED COMMUNITY PHARMACISTS WORKING IN TAYSIDE PATIENT GROUP DIRECTIONS FOR SUPPLY OF VARENICLINE (CHAMPIX ) BY AUTHORISED COMMUNITY PHARMACISTS WORKING IN TAYSIDE GENERAL POLICY 2 PATIENT GROUP DIRECTIONS FOR SUPPLY OF VARENICLINE 4 STANDING ORDER

More information

Shared Care Guidance. Vigabatrin

Shared Care Guidance. Vigabatrin North of Tyne Area Prescribing Committee Shared Care Guidance Vigabatrin July 2014 (Review date July 2016) This guidance has been prepared and approved for use in Newcastle, North Tyneside and Northumberland.

More information

SHARED CARE AGREEMENT: METHOTREXATE S/C

SHARED CARE AGREEMENT: METHOTREXATE S/C NB: This document should be read in conjunction with the current Summary of Product Characteristics (SPC) and BSR Guideline for disease-modifying anti-rheumatic drug (DMARD) therapy (available at www.rheumatology.org.uk/resources/guidelines/bsr_guidelines.aspx

More information

Greater Manchester Interface Prescribing Group Shared Care Guideline

Greater Manchester Interface Prescribing Group Shared Care Guideline Greater Manchester Interface Prescribing Group Shared Care Guideline Shared Care Guideline for Melatonin Circadin Author(s)/Originator(s): Dr Rob Rifkin Paediatrician RI Adele Gothard Paediatric Pharmacist

More information

RELEVANT ACUTE TRUST LOGO WORKING IN PARTNERSHIP WITH

RELEVANT ACUTE TRUST LOGO WORKING IN PARTNERSHIP WITH RELEVANT ACUTE TRUST LOGO WORKING IN PARTNERSHIP WITH Surrey (East Surrey CCG, Guildford & Waverley CCG, North West Surrey CCG, Surrey Downs CCG & Surrey Heath) North East Hampshire & Farnham CCG, Crawley

More information

Liothyronine for treatment resistant depression

Liothyronine for treatment resistant depression DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) SHARED CARE AGREEMENT FRAMEWORK Liothyronine for treatment resistant depression 1. REFERRAL CRITERIA Shared Care is only appropriate if it provides the

More information

SHARED CARE PRESCRIBING GUIDELINE

SHARED CARE PRESCRIBING GUIDELINE WORKING IN PARTNERSHIP East Surrey CCG, Guildford & Waverley CCG, North West Surrey CCG, Surrey Downs CCG, Surrey Heath CCG, North East Hampshire & Farnham CCG, Crawley CCG, Horsham & Mid-Sussex CCG SHARED

More information

keyword: diuretics Drug monitoring Monitoring diuretics in primary care 2 March 2009 best tests

keyword: diuretics Drug monitoring Monitoring diuretics in primary care 2 March 2009 best tests www.bpac.org.nz keyword: diuretics Drug monitoring Monitoring diuretics in primary care 2 March 2009 best tests Why do we monitor patients taking diuretics and what do we monitor? Monitoring a person on

More information

Patient Group Direction for GLUCAGON (Version 02) Valid From 1 October September 2019

Patient Group Direction for GLUCAGON (Version 02) Valid From 1 October September 2019 Version Control This PGD has been agreed by the following organisations FCMS Doncaster CCG Lancashire CCGs including East Lancashire, Fylde and Wyre and North Lancashire CCGs Change history 31/07/17 V02

More information

Rivaroxaban film coated tablets are available in 2 strengths for this indication: 15mg and 20mg.

Rivaroxaban film coated tablets are available in 2 strengths for this indication: 15mg and 20mg. Primary Care Prescriber Information RIVAROXABAN (XARELTO ) Treatment of acute venous thromboembolism and prevention of recurrent venous thromboembolism INDICATION Rivaroxaban is a non-vitamin K antagonist

More information

pat hways Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16

pat hways Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16 pat hways Anticoagulants, including non-vitamin K antagonist oral anticoagulants (NOACs) Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16 Options for local implementation NICE

More information

Guidance for Pharmacists on Safe Supply of Oral Methotrexate

Guidance for Pharmacists on Safe Supply of Oral Methotrexate Guidance for Pharmacists on Safe Supply of Oral Methotrexate Pharmaceutical Society of Ireland Version 2 January 2015 Contents 1. Introduction 2 2. Methotrexate 2 3. Guidance 2 3.1 Patient Review 2 3.2

More information

Products available Methotrexate tablets 2.5mg ONLY (Methotrexate tablets 10mg are NOT recommended as per NPSA guidance 5 ).

Products available Methotrexate tablets 2.5mg ONLY (Methotrexate tablets 10mg are NOT recommended as per NPSA guidance 5 ). Methotrexate Traffic light classification- Amber 1 Information sheet for Primary Care Prescribers Part of the Shared Care Protocol: Management of Rheumatological Conditions with Disease-Modifying Anti

More information

Metformin Hydrochloride

Metformin Hydrochloride Metformin Hydrochloride 500 mg, 850 mg, 500 mg LA and 750 mg LA Tablet Description Informet is a preparation of metformin hydrochloride that belongs to a biguanide class of oral antidiabetic drugs. Metformin

More information

SHARED CARE PROTOCOL CHOLINESTERASE INHIBITORS IN ALZHEIMER S DEMENTIA

SHARED CARE PROTOCOL CHOLINESTERASE INHIBITORS IN ALZHEIMER S DEMENTIA SHARED CARE PROTOCOL CHOLINESTERASE INHIBITORS IN ALZHEIMER S DEMENTIA Introduction Alzheimer s disease is the most common cause of dementia. It is characterised by an insidious onset of global mental

More information

SHARED CARE GUIDELINE FOR RIFAXIMIN FOR PREVENTING EPISODES OF OVERT HEPATIC ENCEPHALOPATHY IN ADULT PATIENTS 1. Aim/Purpose of this Guideline

SHARED CARE GUIDELINE FOR RIFAXIMIN FOR PREVENTING EPISODES OF OVERT HEPATIC ENCEPHALOPATHY IN ADULT PATIENTS 1. Aim/Purpose of this Guideline SHARED CARE GUIDELINE FOR RIFAXIMIN FOR PREVENTING EPISODES OF OVERT HEPATIC ENCEPHALOPATHY IN ADULT PATIENTS 1. Aim/Purpose of this Guideline 1.1. This guideline applies to medical, nursing and pharmacy

More information

MEDICATION GUIDE Savella (Sa-vel-la) (milnacipran HCl) Tablets

MEDICATION GUIDE Savella (Sa-vel-la) (milnacipran HCl) Tablets FDA-Approved Medication Guide MEDICATION GUIDE Savella (Sa-vel-la) (milnacipran HCl) Tablets Savella is not used to treat depression, but it acts like medicines that are used to treat depression (antidepressants)

More information

VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT)

VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT) VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT) Diagnostic Guidelines: Introduction: Electroconvulsive Therapy has been in continuous use for more than 60 years. The clinical literature

More information

Summary of Product Characteristics

Summary of Product Characteristics 1 NAME OF THE MEDICINAL PRODUCT Desunin 4000 IU Tablets Summary of Product Characteristics 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains colecalciferol (vitamin D 3 ) 4000 IU (equivalent

More information

Prescribing Framework for Naltrexone in Relapse Prevention (Opioid Dependence)

Prescribing Framework for Naltrexone in Relapse Prevention (Opioid Dependence) Hull & East Riding Prescribing Committee Prescribing Framework for Naltrexone in Relapse Prevention (Opioid Dependence) Patients Name: Unit Number: Patients Address:.. G.P s Name:.. Communication We agree

More information

SHARED PRESCRIBING GUIDELINE

SHARED PRESCRIBING GUIDELINE working in partnership with Kingston Richmond Wandsworth SHARED PRESCRIBING GUIDELINE Sutton & Merton Methylphenidate, Dexamfetamine and Atomoxetine for Attention Deficit Hyperactivity Disorder in patients

More information

Glucophage XR is contra-indicated during breast-feeding.

Glucophage XR is contra-indicated during breast-feeding. Name GLUCOPHAGE XR 1000 mg Prolonged release tablets Active ingredient Metformin hydrochloride Composition Each Glucophage XR 1000 mg prolonged release tablet contains as active ingredient 1000 mg metformin

More information

MEDICATION GUIDE. Quetiapine (kwe-tye-a-peen) Tablets USP

MEDICATION GUIDE. Quetiapine (kwe-tye-a-peen) Tablets USP MEDICATION GUIDE Quetiapine (kwe-tye-a-peen) Tablets USP Read this Medication Guide before you start taking quetiapine tablets and each time you get a refill. There may be new information. This information

More information

PATIENT INFORMATION LEAFLET. Calcichew* 500 mg Chewable Tablets calcium carbonate

PATIENT INFORMATION LEAFLET. Calcichew* 500 mg Chewable Tablets calcium carbonate PATIENT INFORMATION LEAFLET Calcichew* 500 mg Chewable Tablets calcium carbonate Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

More information

DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC)

DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) Derbyshire Formulary for Nicotine Replacement Therapy (NRT) 1. Supporting Smokers to stop smoking The most effective method to quit smoking is by quitting

More information

Treatment Options for Bipolar Disorder Contents

Treatment Options for Bipolar Disorder Contents Keeping Your Balance Treatment Options for Bipolar Disorder Contents Medication Treatment for Bipolar Disorder 2 Page Medication Record 5 Psychosocial Treatments for Bipolar Disorder 6 Module Summary 8

More information

European PSUR Work Sharing Project CORE SAFETY PROFILE. Lendormin, 0.25mg, tablets Brotizolam

European PSUR Work Sharing Project CORE SAFETY PROFILE. Lendormin, 0.25mg, tablets Brotizolam European PSUR Work Sharing Project CORE SAFETY PROFILE Lendormin, 0.25mg, tablets Brotizolam 4.2 Posology and method of administration Unless otherwise prescribed by the physician, the following dosages

More information

Product Name Strength Pharmaceutical Form. Valproat-Ratiopharm Chrono 300 mg. Valproat-Ratiopharm Chrono 500 mg

Product Name Strength Pharmaceutical Form. Valproat-Ratiopharm Chrono 300 mg. Valproat-Ratiopharm Chrono 500 mg ANNEX I LIST OF THE NAMES, PHARMACEUTICAL FORMS, STRENGTHS OF THE MEDICINAL PRODUCTS, ROUTE OF ADMINISTRATION, MARKETING AUTHORISATION HOLDERS IN THE MEMBER STATES (EU/EEA) 1 Member State (EU/EEA) Czech

More information

ACE. Inhibitors. Quiz feedback

ACE. Inhibitors. Quiz feedback ACE Inhibitors Quiz feedback bpac nz better medicin e bpac nz Quiz feedback, ACE inhibitors, 2006 Best Practice Advocacy Centre ACE inhibitors quiz feedback bpac nz Development Team: Rachael Clarke Sonia

More information

Integrated Care Pathway (ICP) for the. Management of clozapine INPATIENT INITIATION

Integrated Care Pathway (ICP) for the. Management of clozapine INPATIENT INITIATION Document Reference MM 048 Integrated Care Pathway (ICP) for the Management of clozapine INPATIENT INITIATION Surname Title Address Forenames Date of Birth RT/NHS number Care Co-ordinator GP CS number Consultant

More information

NEW ZEALAND DATA SHEET 1. PRIADEL MODIFIED RELEASE TABLETS 400 MG 2. QUALITATIVE AND QUANTITATIVE COMPOSITION

NEW ZEALAND DATA SHEET 1. PRIADEL MODIFIED RELEASE TABLETS 400 MG 2. QUALITATIVE AND QUANTITATIVE COMPOSITION NEW ZEALAND DATA SHEET 1. PRIADEL MODIFIED RELEASE TABLETS 400 MG 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 400 mg lithium carbonate. For full list of excipients, see section 6.1.

More information

Adult Neurodevelopmental Services. ADHD Shared Protocol

Adult Neurodevelopmental Services. ADHD Shared Protocol Adult Neurodevelopmental Services ADHD Shared Protocol Issue 1: April 2016 1 2 Adult Neurodevelopmental Service Shared Care Protocol for Adult Attention Deficit Hyperactivity Disorder (ADHD) 1. BACKGROUND

More information

GLUCOPHAGE 500 mg Merck Serono

GLUCOPHAGE 500 mg Merck Serono GLUCOPHAGE 500 mg Film-coated tablets Composition Film-coated tablets containing 500 mg of metformin (INN) hydrochloride (equivalent to 390 mg of metformin Excipients Polyvidone K 30, magnesium stearate,

More information

DATA SHEET 2 QUALITATIVE AND QUANTITATIVE COMPOSITION

DATA SHEET 2 QUALITATIVE AND QUANTITATIVE COMPOSITION DATA SHEET 1 PRODUCT NAME 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Sachet, each 5.1g sachet contains: Sodium chloride 470mg, potassium chloride 300mg, sodium acid citrate 530mg, glucose 3.56g. Tablet,

More information

Medication for the Treatment of Alcohol Use Disorder. Pocket Guide

Medication for the Treatment of Alcohol Use Disorder. Pocket Guide Medication for the Treatment of Alcohol Use Disorder Pocket Guide Medications are underused in the treatment of alcohol use disorder. According to the National Survey on Drug Use and Health, of the estimated

More information

ZONISAMIDE THERAPEUTICS. Brands * Zonegran. Generic? Not in US. If It Doesn t Work * Class Antiepileptic drug (AED), structurally a sulfonamide

ZONISAMIDE THERAPEUTICS. Brands * Zonegran. Generic? Not in US. If It Doesn t Work * Class Antiepileptic drug (AED), structurally a sulfonamide Z:/3-PAGINATION/SBT/2-PROOFS/NWMS/9780521136723C111//9780521136723C111.3D 376 [376 380] ZONISAMIDE Brands Zonegran Generic? Not in US THERAPEUTICS Class Antiepileptic drug (AED), structurally a sulfonamide

More information

Tolvaptan (Jinarc ) for Adult Polycystic Kidney Disease (ADPKD)

Tolvaptan (Jinarc ) for Adult Polycystic Kidney Disease (ADPKD) Oxford Kidney Unit Tolvaptan (Jinarc ) for Adult Polycystic Kidney Disease (ADPKD) Information for patients What is tolvaptan? Tolvaptan (Jinarc ) is the first drug specifically for the treatment of adult

More information

Surveillance report Published: 8 June 2017 nice.org.uk. NICE All rights reserved.

Surveillance report Published: 8 June 2017 nice.org.uk. NICE All rights reserved. Surveillance report 2017 Antenatal and postnatal mental health: clinical management and service guidance (2014) NICE guideline CG192 Surveillance report Published: 8 June 2017 nice.org.uk NICE 2017. All

More information

Bipolar Disorder Clinical Practice Guideline Summary for Primary Care

Bipolar Disorder Clinical Practice Guideline Summary for Primary Care Bipolar Disorder Clinical Practice Guideline Summary for Primary Care DIAGNOSIS AND CLINICAL ASSESSMENT Bipolar Disorder is categorized by extreme mood cycling; manifested by periods of euphoria, grandiosity,

More information

MEDICATION GUIDE Valproic Acid (val pro ic acid) Capsules

MEDICATION GUIDE Valproic Acid (val pro ic acid) Capsules MEDICATION GUIDE Valproic Acid (val pro ic acid) Capsules Read this Medication Guide before you start taking Valproic Acid Capsules and each time you get a refill. There may be new information. This information

More information

New Zealand Data Sheet. Arrow-Bendrofluazide Bendroflumethiazide (also known as Bendrofluazide) Tablets 2.5mg and 5mg

New Zealand Data Sheet. Arrow-Bendrofluazide Bendroflumethiazide (also known as Bendrofluazide) Tablets 2.5mg and 5mg New Zealand Data Sheet Arrow-Bendrofluazide Bendroflumethiazide (also known as Bendrofluazide) Tablets 2.5mg and 5mg Description Arrow-Bendrofluazide Tablets contain 2.5 and 5 mg of the active ingredient

More information

Elavil (amitriptyline)

Elavil (amitriptyline) Generic name: Amitriptyline Available strengths: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg tablets; 10 mg/ml injection Available in generic: Yes Drug class: Tricyclic antidepressant General Information

More information

SUMMARY OF PRODUCT CHARACTERISTICS FOR BENZODIAZEPINES AS ANXIOLYTICS OR HYPNOTICS

SUMMARY OF PRODUCT CHARACTERISTICS FOR BENZODIAZEPINES AS ANXIOLYTICS OR HYPNOTICS SUMMARY OF PRODUCT CHARACTERISTICS FOR BENZODIAZEPINES AS ANXIOLYTICS OR HYPNOTICS Guideline Title Summary of Product Characteristics for Benzodiazepines as Anxiolytics or Hypnotics Legislative basis Directive

More information

PRODUCT INFORMATION RESONIUM A. Na m

PRODUCT INFORMATION RESONIUM A. Na m PRODUCT INFORMATION RESONIUM A NAME OF THE MEDICINE Non-proprietary Name Sodium polystyrene sulfonate Chemical Structure CH - 2 CH SO 3 Na + n CAS Number 28210-41-5 [9003-59-2] CH 2 CH SO - 3 m DESCRIPTION

More information

Cetirizine Proposed Core Safety Profile

Cetirizine Proposed Core Safety Profile Cetirizine Proposed Core Safety Profile Posology and method of administration Elderly subjects: data do not suggest that the dose needs to be reduced in elderly subjects provided that the renal function

More information

* Adults. NSAID associated peptic ulceration: - Acute treatment: 150 mg twice daily for 8 to 12 weeks, or 300mg nocte.

* Adults. NSAID associated peptic ulceration: - Acute treatment: 150 mg twice daily for 8 to 12 weeks, or 300mg nocte. Trade Name Aciloc 75 mg & 300 mg Film-coated tablets Generic Name Ranitidine Composition Each Aciloc 300 mg film-coated tablet contains: - Active ingredient: Ranitidine hydrochloride 336 mg equivalent

More information

HYPONATRAEMIA GUIDELINES

HYPONATRAEMIA GUIDELINES HYPONATRAEMIA GUIDELINES Na + < 130 mmol/l For all patients: Acute = onset < 48 hours Chronic = onset > 48 hours or not known Follow acute hyponatraemia flow chart on page 2 Follow chronic hyponatraemia

More information

Initiation of Clozapine Treatment Community Patients

Initiation of Clozapine Treatment Community Patients Initiation of Clozapine Treatment Community Patients Who Should Read This Policy Target Audience All clinical staff working in the community N/A N/A Initiation of Clozapine Treatment for Patients in the

More information

All patients put on this combination must have been seen by a dietitian and made appropriate efforts to lose weight

All patients put on this combination must have been seen by a dietitian and made appropriate efforts to lose weight Shared Care Protocol: Addition of a glucagonlike peptide-1 (GLP-1) analogues (exenatide or liraglutide) to patients already on insulin who have poorly controlled type 2 diabetes All patients put on this

More information

Essential Shared Care Agreement: Melatonin (Circadin, Bio-Melatonin)

Essential Shared Care Agreement: Melatonin (Circadin, Bio-Melatonin) Ref No: E056 Essential Shared Care Agreement: Melatonin (Circadin, Bio-Melatonin) Please complete the following details: Patient s name, address, date of birth, and either complete when the consultant

More information

Information for health professionals

Information for health professionals Introduction of a new screening test for newborn babies in Wales Newborn bloodspot screening for Medium chain acyl-coa dehydrogenase deficiency (MCADD) Newborn bloodspot screening for MCADD is being introduced

More information

Active ingredients: Metoclopramide Hydrochloride mg Equivalent to metoclopramide hydrochloride anhydrous mg

Active ingredients: Metoclopramide Hydrochloride mg Equivalent to metoclopramide hydrochloride anhydrous mg Name Primperan 10 mg / 2 ml Metoclopramide hydrochloride anhydrous Solution for I.M. or I.V. injection (Ampoules) Composition Each 2 ml ampoule contains: Active ingredients: Metoclopramide Hydrochloride.

More information

BNSSG Shared Care Guidance Please complete all sections

BNSSG Shared Care Guidance Please complete all sections NHS Bristol CCG NHS North Somerset CCG NHS South Gloucestershire CCG North Bristol NHS Trust University Hospitals Bristol NHS Foundation Trust Weston Area Health NHS Trust BNSSG Shared Care Guidance Please

More information

SANDOMIGRAN (pizotifen malate)

SANDOMIGRAN (pizotifen malate) SANDOMIGRAN (pizotifen malate) S N CH 3 Pizotifen. COOH CH OH CH 2 COOH MALATE DESCRIPTION Pizotifen is a cycloheptathiophene derivative structurally related to cyproheptadine and the tricyclic antidepressants.

More information

P-RMS: FR/H/PSUR/0036/001

P-RMS: FR/H/PSUR/0036/001 Core Safety Profile Active substance: Alprazolam Pharmaceutical form(s)/strength: Tablet uncoated, sugar coated, film coated, 0.25mg Tablet uncoated, 0.4 mg Tablet uncoated, sugar coated, film coated,

More information

GLEEVEC (imatinib mesylate) PATIENT RESOURCES

GLEEVEC (imatinib mesylate) PATIENT RESOURCES Talking with your doctor about Ph+ CML and its treatment When you have Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML), it s important to take an active role in your care. You will

More information

PATIENT INFORMATION LEAFLET

PATIENT INFORMATION LEAFLET PATIENT INFORMATION LEAFLET CALCICHEW*-D 3 FORTE 500 mg/400 IU CHEWABLE TABLETS calcium/colecalciferol Read all of this leaflet carefully because it contains important information for you. - Always take

More information

M0BCore Safety Profile. Active substance: Bromazepam Pharmaceutical form(s)/strength: Tablets 6 mg FR/H/PSUR/0066/001 Date of FAR:

M0BCore Safety Profile. Active substance: Bromazepam Pharmaceutical form(s)/strength: Tablets 6 mg FR/H/PSUR/0066/001 Date of FAR: M0BCore Safety Profile Active substance: Bromazepam Pharmaceutical form(s)/strength: Tablets 6 mg P-RMS: FR/H/PSUR/0066/001 Date of FAR: 26.11.2013 4.3 Contraindications Bromazepam must not be administered

More information

Metoclopramide hydrochloride mg (Quantity corresponding to anhydrous metoclopramide hydrochloride) mg

Metoclopramide hydrochloride mg (Quantity corresponding to anhydrous metoclopramide hydrochloride) mg Name Primperan 10 mg Breakable tablets Metoclopramide hydrochloride Before taking this medicine Carefully read the entirety of this leaflet before taking this medicine. It contains important information

More information

Clinical Guideline Bone chemistry management in adult renal patients on dialysis

Clinical Guideline Bone chemistry management in adult renal patients on dialysis Clinical Guideline Bone chemistry management in adult renal patients on dialysis This guidance covers how to: Maintain serum phosphate 0.8 to 1.7mmol/L 1 Maintain serum corrected calcium 2.1 to 2.5mmol/L

More information

Care Homes - Homely Remedies Protocol

Care Homes - Homely Remedies Protocol Care Homes - Homely Remedies Protocol A homely remedy is a medicine for the short-term treatment of a minor ailment, such as indigestion, a cough, mild to moderate pain or constipation, and can be obtained

More information

CONSUMER MEDICINE INFORMATION

CONSUMER MEDICINE INFORMATION CONSUMER MEDICINE INFORMATION Arrow - Tramadol Tramadol 50 mg capsules What is in this leaflet This leaflet answers some common questions about ARROW - TRAMADOL. It does not contain all of the available

More information

BNSSG Shared Care Guidance

BNSSG Shared Care Guidance NHS Bristol NHS North Somerset NHS South Gloucestershire North Bristol University Hospitals Bristol NHS Foundation Trust Weston Area Health BNSSG Shared Care Guidance Amber Three Months Section 1: Heading

More information

NEW ZEALAND DATA SHEET

NEW ZEALAND DATA SHEET 1 PRODUCT NAME MINIRIN 0.1mg/mL nasal drops MINIRIN 0.1mg/mL Nasal Drops Desmopressin acetate 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each 1mL contains 0.1mg desmopressin acetate which corresponds to

More information

Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90

Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90 Depression in adults: recognition and management Clinical guideline Published: 28 October 2009 nice.org.uk/guidance/cg90 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).

More information

SUMMARY OF PRODUCT CHARACTERISTICS. One chewable tablet contains 1250 mg calcium carbonate (equivalent to 500 mg calcium).

SUMMARY OF PRODUCT CHARACTERISTICS. One chewable tablet contains 1250 mg calcium carbonate (equivalent to 500 mg calcium). SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE MEDICINAL PRODUCT [XXX] 500 mg chewable tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION One chewable tablet contains 1250 mg calcium carbonate (equivalent

More information

NHS Dumfries & Galloway Ferrous Salt Review Protocol November 09

NHS Dumfries & Galloway Ferrous Salt Review Protocol November 09 Title of Project: NHS Dumfries & Galloway Ferrous Salt Review Protocol November 09 1 Reason for the review Choice of iron preparation is based on cost and incidence of side effects (BNF). There is little

More information

Questions to ask your Doctor

Questions to ask your Doctor Questions to ask your Doctor What is my current blood pressure? What are my target blood pressure numbers? What blood pressure medication(s) am I currently taking? How is this drug different from what

More information

Safe Prescribing of Drugs with Potential for Misuse/Diversion

Safe Prescribing of Drugs with Potential for Misuse/Diversion College of Physicians and Surgeons of British Columbia Safe Prescribing of Drugs with Potential for Misuse/Diversion Preamble This document establishes both professional standards as well as guidelines

More information

A guide to the treatment and management of Childhood Nephrotic Syndrome

A guide to the treatment and management of Childhood Nephrotic Syndrome A guide to the treatment and management of Childhood Nephrotic Syndrome CONTENTS Introduction What is Nephrotic Syndrome? What is the cause of Nephrotic Syndrome? What is the treatment? Side-effects of

More information

Amiodarone. Traffic light classification- Amber 2 Information sheet for Primary Care Prescribers

Amiodarone. Traffic light classification- Amber 2 Information sheet for Primary Care Prescribers Amiodarone Traffic light classification- Amber 2 Information sheet for Primary Care Prescribers Licensed Indications Tachyarrhythmias associated with Wolff-Parkinson-White syndrome All types of tachyarrhythmias

More information

StRs and CT doctors in haematology. September Folinic acid dose modified.

StRs and CT doctors in haematology. September Folinic acid dose modified. High dose Methotrexate and folinic acid rescue Full Title of Guideline: Author (include email and role): Division & Speciality: Clinical Guideline Review Date September 2018 GUIDELINE FOR THE USE OF HIGH

More information

Drug Misuse and Dependence Guidelines on Clinical Management

Drug Misuse and Dependence Guidelines on Clinical Management Department of Health Scottish Office Department of Health Welsh Office Department of Health and Social Services, Northern Ireland Drug Misuse and Dependence Guidelines on Clinical Management An Executive

More information

Prescribing Framework for Lisdexamfetamine for Attention Deficit Hyperactivity Disorder

Prescribing Framework for Lisdexamfetamine for Attention Deficit Hyperactivity Disorder Hull & East Riding Prescribing Committee Prescribing Framework for Lisdexamfetamine for Attention Deficit Hyperactivity Disorder Patient s Name:.. NHS Number: Patient s Address:... (Use addressograph sticker)

More information

PIL. ParaCet Flu 500 mg+250 mg/sachet Powder for oral solution paracetamol + ascorbic acid

PIL. ParaCet Flu 500 mg+250 mg/sachet Powder for oral solution paracetamol + ascorbic acid PIL ParaCet Flu 500 mg+250 mg/sachet Powder for oral solution paracetamol + ascorbic acid Please, carefully read this PIL before you start using the medicine. This medicine is available without prescription,

More information

Wellbutrin/Wellbutrin-SR/ Wellbutrin-XL (bupropion)

Wellbutrin/Wellbutrin-SR/ Wellbutrin-XL (bupropion) Wellbutrin/Wellbutrin-SR/ Wellbutrin-XL (bupropion) Generic name: Bupropion Available strengths: 75 mg, 100 mg immediate-release tablets; 100 mg, 150 mg, 200 mg sustained-release tablets (Wellbutrin-SR);

More information

NEW ZEALAND DATA SHEET

NEW ZEALAND DATA SHEET 1. PRODUCT NAME Sudomyl, Tablet, 60 mg 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Name and strength of the active substance Pseudoephedrine Hydrochloride 60mg Excipient(s) with known effect For the full

More information

HYPONATRAEMIA: NUH GUIDELINE FOR INITIAL ASSESSMENT AND MANAGEMENT.

HYPONATRAEMIA: NUH GUIDELINE FOR INITIAL ASSESSMENT AND MANAGEMENT. HYPONATRAEMIA: NUH GUIDELINE FOR INITIAL ASSESSMENT AND MANAGEMENT. HYPONATRAEMIA: SODIUM < 130 MMOL/L SIGNIFICANT. Symptoms/signs usually only occur when sodium < 125 mmol/l. Acute hyponatraemia is less

More information

2. What you need to know before you take DDAVP/Desmopressin Tablets

2. What you need to know before you take DDAVP/Desmopressin Tablets Package Leaflet: Information for the user DDAVP /Desmopressin 0.1mg Tablets Desmopressin Acetate Read all of this leaflet carefully before you start taking this medicine because it contains important information

More information

Depression: management of depression in primary and secondary care

Depression: management of depression in primary and secondary care Issue date: December 2004, with amendments April 2007 Quick reference guide (amended) Depression: management of depression in primary and secondary care Amendment of recommendations concerning venlafaxine:

More information

Consumer Medicine Information

Consumer Medicine Information Consumer Medicine Information TRAMAL SR Tramadol hydrochloride Sustained Release Tablets What is in this leaflet? This leaflet answers some common questions about Tramal SR. It does not contain all the

More information

Donepezil, Galantamine, Rivastigmine and Memantine

Donepezil, Galantamine, Rivastigmine and Memantine Donepezil, Galantamine, Rivastigmine and Memantine ESCA: For treatment of Alzheimer's disease AREAS OF RESPONSIBILITY FOR THE SHARING OF CARE This shared care agreement outlines suggested ways in which

More information

NEW ZEALAND DATA SHEET

NEW ZEALAND DATA SHEET NEW ZEALAND DATA SHEET LITHICARB FC 1. Product Name LITHICARB FC 250 mg and 400 mg, film coated tablets. 2. Qualitative and Quantitative Composition Each film coated tablet contains 250 mg or 400 mg of

More information

Clinical Guideline for the management of inpatients with Parkinson s disease

Clinical Guideline for the management of inpatients with Parkinson s disease Clinical Guideline for the management of inpatients with Parkinson s disease Introduction: Parkinson s disease (PD) is the second most common neurodegenerative disorder, characterised by bradykinesia,

More information

New Zealand Data Sheet

New Zealand Data Sheet New Zealand Data Sheet 1. PRODUCT NAME Lithium Carbonate 250mg Capsule. 2. QUALITATIVE AND QUATITATIVE COMPOSITION Each tablet contains 250mg of the active substance lithium carbonate. For the full list

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. <PRODUCT NAME> 600 mg / 1,000 IU orodispersible tablets. Calcium/cholecalciferol (Vitamin D3)

PACKAGE LEAFLET: INFORMATION FOR THE USER. <PRODUCT NAME> 600 mg / 1,000 IU orodispersible tablets. Calcium/cholecalciferol (Vitamin D3) PACKAGE LEAFLET: INFORMATION FOR THE USER 600 mg / 1,000 IU orodispersible tablets Calcium/cholecalciferol (Vitamin D3) Read all of this leaflet carefully before you start taking this medicine

More information

Aripiprazole Long-Acting Injection (Abilify Maintena ) Guidelines for Prescribing and Administration (Version 3 August 2014)

Aripiprazole Long-Acting Injection (Abilify Maintena ) Guidelines for Prescribing and Administration (Version 3 August 2014) 1. Key Points. Aripiprazole Long-Acting Injection (Abilify Maintena ) Guidelines for Prescribing and Administration (Version 3 August 2014) 1.1 Aripiprazole long acting injection (LAI) is licensed / indicated

More information

Magnesium Sulphate - Management of Hypertensive Disorders of Pregnancy

Magnesium Sulphate - Management of Hypertensive Disorders of Pregnancy 1. Purpose Magnesium sulphate is the anticonvulsant of choice for pre-eclampsia prophylaxis and treatment. This clinical guideline outlines the indications, contraindications, administration and monitoring

More information

Amiodarone Therapy. Exceptional healthcare, personally delivered

Amiodarone Therapy. Exceptional healthcare, personally delivered Amiodarone Therapy Exceptional healthcare, personally delivered Your information Name: Address: Postcode: Home telephone: Mobile telephone: Hospital number: Name of GP: Address: Postcode: Telephone number:

More information

Appendix F Federation of State Medical Boards

Appendix F Federation of State Medical Boards Appendix F Federation of State Medical Boards Model Policy Guidelines for Opioid Addiction Treatment in the Medical Office SECTION I: PREAMBLE The (name of board) recognizes that the prevalence of addiction

More information

contains the active ingredient diazepam It does not contain all the available information.

contains the active ingredient diazepam It does not contain all the available information. VALIUM pronounced (val-i-um) contains the active ingredient diazepam Consumer Medicine Information What is in this leaflet This leaflet answers some common questions about VALIUM. It does not contain all

More information

NCCP Chemotherapy Protocol. Afatinib Monotherapy

NCCP Chemotherapy Protocol. Afatinib Monotherapy Afatinib Monotherapy INDICATIONS FOR USE: INDICATION Treatment of Epidermal Growth Factor Receptor (EGFR) TKI- naïve adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC)

More information

Package leaflet: Information for the patient. Clarithromycin Kern Pharma 500 film-coated tablets Clarithromycin

Package leaflet: Information for the patient. Clarithromycin Kern Pharma 500 film-coated tablets Clarithromycin Package leaflet: Information for the patient Clarithromycin Kern Pharma 500 film-coated tablets Clarithromycin Read all of this leaflet carefully before you start taking this medicine because it contains

More information

SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program

SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets Risk Evaluation and Mitigation Strategy (REMS) Program Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Prescribers

More information

Summary of the risk management plan (RMP) for Jinarc (tolvaptan)

Summary of the risk management plan (RMP) for Jinarc (tolvaptan) EMA/156109/2015 Summary of the risk management plan (RMP) for Jinarc (tolvaptan) This is a summary of the risk management plan (RMP) for Jinarc, which details the measures to be taken in order to ensure

More information