Latest edition of Australian Prescriber out now

The latest edition of Australian Prescriber is out now and looks at the following issues:

Drug-induced sexual dysfunction in men and women

Many medical conditions and their treatments have sexual adverse effects in both men and women, and can reduce a patient's adherence to treatment.

Understanding the potential for these drug-induced sexual problems — and their negative impact on adherence — will help health professionals tailor treatments for patients and their partners, write Dr Helen Conaglen, clinical psychologist, and Associate Professor John Conaglen, endocrinologist, both from the University of Auckland.

Some commonly implicated drugs affecting sexual function include antihypertensives, antidepressants and antipsychotics, as well as recreational drugs. The authors examine each of these and explain some useful clinical approaches. Encouraging a discussion with the patient about sexual function and providing strategies to manage the problem are critical to good clinical care, write the authors.

Folate for therapy

Folic acid supplementation in pregnancy prevents neural tube defects. It is also recommended to reduce the risk of some adverse effects in patients receiving low-dose methotrexate for rheumatic diseases.

However, rheumatologists Dr Serena Parker, Dr Patrick Hanrahan and Dr Claire Barrett write that in the general population, supplements have no clear benefit in reducing the risk of cardiovascular disease or dementia. There is also conflicting evidence about cancer prevention, with some studies suggesting that folic acid supplements increase the risk of malignancy.

Metformin: myths, misunderstandings and lessons from history

The story of how metformin came to be one of the most prescribed drugs in the world teaches some important lessons about how some drugs come to be widely accepted, writes Professor Gillian Shenfield, consultant pharmacologist, Sydney.

For decades metformin was banned in many countries but its benefits were rediscovered and it is now the drug of first choice for patients with type 2 diabetes in the USA and Europe, and the National Health and Medical Research Council in Australia is considering a similar recommendation. There were 100 million prescriptions worldwide in 2010 for metformin alone and in combination tablets.

Professor Shenfield examines the lessons from the metformin saga, including how drugs can sometimes produce more benefits than first claimed. She draws parallels with other medicines such as aspirin, where there has been a long delay in translating evidence into practice.

Other articles in this edition of Australian Prescriber include:

To read the full articles and more visit


Independent, evidence-based and not-for-profit, NPS MedicineWise enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published every two months and distributed to health professionals free of charge, and is also available online at 

Media enquiries: Stephanie Childs on 02 8217 8667, 0419 618 365 or