19 May 2010

Written by the National Prescribing Service, 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 online update of NPS RADAR:

Methoxyflurane (Penthrox): doctor’s bag listing

Methoxyflurane (Penthrox) provides rapid-onset short-term analgesia for the initial management of acute trauma pain (while the patient is conscious) and brief painful procedures such as wound dressing. It is a disposable, single-use inhaler device, enabling self-adminstration under supervision.

This product is currently used by ambulance crews and is now available on the PBS for the doctor’s bag only. Prescribers should note the likelihood of renal toxicity if used above recommended doses or on consecutive days.

Melatonin prolonged-release tablets (Circadin) for primary insomnia in older people

Melatonin has been approved by the TGA for sale in Australia however it is not PBS-listed. This product may be perceived as safe because it is naturally-occurring and few safety issues have been identified safety with short-term use. However its long-term adverse effect profile is currently unknown. Research shows only 1 in 3 people who use it will experience a clinically meaningful improvement in their quality of sleep and morning alertness.

Prescribers treating patients with insomnia are encouraged to refer to the NPS hypnotics program from February 2010, which recommends investigating potential causes and prescribing non-drug therapies as the initial treatment. For further information go to www.nps.org.au/nps_news

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

Prescribers are advised that lower doses of colchicines are now recommended for acute gout. Recent trial evidence demonstrates that low-dose colchicine for acute gout is as effective as a higher dose, but with a reduced risk of adverse effects. Toxicity may also result through drug interactions with commonly prescribed medicines, including some antibiotics and statins.

The National Prescribing Service Limited (NPS) is an independent, not-for-profit organisation for quality use of medicines funded by the Australian Government Department of Health and Ageing.