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Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board.
We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.

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NPS Media Releases August 2010

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	NPS Spokesperson articles by this author...
Regular information provided by NPS – Better choices, better health - NPS enables people to be medicinewise.

The National Prescribing Service (NPS) is a valued independent resource for accurate, evidence-based prescribing information and education.
Given the marketing pressures applied by global drug companies, NPS plays a vital and unique role across the healthcare sector.
For more information please contact Katie Butt, NPS Media Adviser, 02 8217 8667 or kbutt@nps.org.au

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24 August 2010

Independent reviews of new type 2 diabetes medicines help people be medicinewise 

People with type 2 diabetes can find independent reviews of two new blood glucose lowering medicines in the latest edition of Medicine Update, a newsletter published by NPS – better choices, better health. NPS (formerly known as the National Prescribing Service) is an independent organisation that enables people to be medicinewise.

The reviews of Januvia (sitagliptin) and Galvus (vildagliptin) outline who the medicines are suitable for, how they work and ways in which they differ from existing medicines for type 2 diabetes. Both articles also discuss possible side effects of these and other medicines for diabetes.

Karen Kaye, acting CEO of NPS, says anyone with type 2 diabetes who is considering one of these new medicines should read the Medicine Update before having a discussion with their doctor.

“Medicine Update provides people with an independent clinical review of new medicines in a language they can understand. It outlines clearly what people need to consider before starting these medicines and how the medicines differ from existing medicine choices,” Ms Kaye said.

“The medicines you take for your diabetes may change over time. For example, you might only need a single tablet to control your blood glucose initially, but diabetes tends to get worse as you get older. At some point your doctor may recommend that you take more than one type of tablet, or that you take insulin, or a combination of tablets and insulin. Each medicine will work in a different way to control your blood glucose level.”

Both Januvia (sitagliptin) and Galvus (vildagliptin) are relatively new medicines available in tablet form. They can be used by people with type 2 diabetes whose blood glucose cannot be controlled effectively with certain other medicines. Neither medicine is designed to be taken on its own – you will need to continue taking your other diabetes medicine too.

Although both medicines have been through the required clinical trials and have been shown to lower blood glucose, they are quite new so it is not yet known if they can reduce the long term complications of diabetes.

“Before starting any new medicine talk to your doctor and pharmacist about how they work, potential side effects and whether it is definitely the best medicine for you. Educate yourself about your medicine options so you can have a well-informed discussion with your health professionals and be an active partner in your own health care,” Ms Kaye said.

To view the full reviews go to www.nps.org.au/medicineupdate

4 August 2010
Gliptins and Adrenaline autoinjector reviewed in latest edition of NPS RADAR

 NPS RADAR is a timely publication containing independent, evidence-based assessments of new drugs, new PBS listings and the latest research for doctors, pharmacists and other health professionals.

The following medicines are reviewed in the latest edition:

Gliptins

Sitagliptin (Januvia) and vildagliptin (Galvus) are two drugs from a relatively new class of dipeptidyl peptidase-4 (DPP-4) inhibitors - or ‘gliptins’. Vildagliptin (Galvus) is available on the PBS from 1 August.

Before prescribing these medicines doctors should consider the following:

• Both gliptins provide similar improvements in glycaemic control for people with type 2 diabetes mellitus.
• Gliptins are not associated with weight gain or an increased risk of hypoglycaemia.
• The effect of gliptins on diabetes-related complications and mortality is unknown.
• Weight gain or hypoglycaemia can still occur when a gliptin is used with a sulfonylurea
• The long-term benefit–harm profile of gliptins is yet to be established.

Adrenaline autoinjector (Anapen)

Anapen is a new autoinjector for the emergency treatment of anaphylaxis. Prior to its listing there was only one form of adrenaline autoinjector – the Epipen brand.

Before prescribing Anapen, doctors should note that Anapen has a substantially different administration technique to that of EpiPen, but has a clinically equivalent effect. Due to the potential for confusion when administering adrenaline in an emergency, patients and carers including schools need to be aware of the differences between the two devices.

Brief reviews of the following medicines are also in this edition of NPS RADAR:

v  Paracetamol with caffeine (Panadol Extra) available over the counter from pharmacies 

v  Colchicine for acute gout: updated information about dosing and drug interactions

v  PBS listing of extended-release pramipexole (Sifrol ER) for Parkinson’s disease

v  Anakinra (Kineret) to be deleted from the PBS

v  Exenatide (Byetta): first in another new class of diabetes drugs

To read the full reviews go to www.nps.org.au/radar

 

2 August 2010
Question mark over combination pain relief products

Codeine is a weak opioid used in many combination pain relief products, but its role in managing acute pain is questioned in this month’s edition of Australian Prescriber.

In the article Dr Bridin Murnion, from the Drug Health Service at Royal Prince Alfred Hospital Sydney, discusses the evidence around combinations of different painkillers in the same tablet (eg. ibuprofen or paracetamol with codeine). She argues that in many cases pain relief is not increased by using two different painkillers.

“Codeine is often an ingredient in combination painkillers, however there is not much evidence for its effectiveness and the role of codeine in managing acute pain is unclear,” says Dr Murnion.

NPS’s review of evidence shows that studies in acute pain suggest only modest additional pain relief is achieved when codeine is added to paracetamol, and the risk of side effects increases after repeated doses.

As an opioid, codeine can be addictive. When people take it in higher doses than recommended, they are also taking high doses of the other pain relief ingredients, paracetamol or ibuprofen, and it’s these ingredients which, when misused, can cause serious adverse events such as stomach and liver damage.

A National Health and Medical Research Council review found insufficient evidence to recommend the use of paracetamol/codeine combinations in acute low back pain, acute neck pain, acute shoulder pain or acute knee pain.

“For dental pain, the most effective approach is to undertake appropriate dental treatment. After dental extraction, anti-inflammatory medications are better than combinations of paracetamol and codeine,” Dr Murnion advises.

While there is a significant body of evidence identifying the efficacy of NSAIDs (e.g. ibuprofen, aspirin, diclofenac) in acute pain, there are limited data on combining them with opioids.

“Many anti-inflammatory drugs are more effective than combinations of codeine with paracetamol or aspirin,” she writes.

Dr Murnion says the recent rescheduling of these products is unlikely to impact significantly on people’s pain relief options but may reduce the harms from overuse.

These findings are in line with NPS reviews of evidence that show when treating acute pain, only modest additional pain relief is achieved when codeine is added to other analgesics.

“As a weak opioid, codeine can be addictive but because it can’t be purchased without either paracetamol, aspirin or ibuprofen, people end up consuming more than they need of these products too,” NPS acting CEO, Karen Kaye said.

“Taking more than the recommended maximum amount of these products can result in serious side effects. Overuse or misuse of products containing aspirin or ibuprofen can result in gastric ulcer perforation, or in products containing paracetmol, liver toxicity or death.”

“The recent rescheduling of these products ensures people using these products will get the professional advice from a pharmacist and addictions will be identified.”

To view the full article go to www.australianprescriber.com

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