by Kazeem Olalekan
The following are some of the latest important updates from the newly April 2014 release of the BNF and BNFc:
“There is no evidence to show that any oral preparation of mesalazine is more effective than another, however delivery characteristics of oral mesalazine preparations may vary. If it is necessary to switch a patient to a different brand of mesalasine, the patient should be advised to report any changes in symptoms”
How will this affect my practise?
I am free to start a new patient on whatever brand of mesalazine (whatever the local policy) and it will be fine. There shouldn’t be a need to change to another product on efficacy grounds. However, some patient may not get along with the brand prescribed for a number of reasons: big tablets; bad taste etc. If I do change brand, the symptom control may be affected and titration of the new brand may be necessary to get symptom control again…so I will let the patient be my eyes and ears for any changes in symptoms control.
Following from
previous update on restriction of Metoclopramide in children, the recommended dose is:
100 – 150 microgram/kg, repeated up to 3 times a day
IV doses should be administered as a slow bolus over at least 3 minutes.
There is an increased risk of venous thromboembolic disease in users of combined hormonal contraceptives, particularly during the first year and possibly after restarting combined hormonal contraceptives following break of four weeks or more. In all cases the risk of venous thromboembolism increases with age & other risk factors, such as obesity, diabetes etc.
Risk is considerably smaller than that associated with pregnancy….but:
There are others: Do look at the
BNFand
BNFc websites
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