The Pharmaceutical Journal
Vol 272 No 7282 p51
17 January 2004

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Products

Prescription Products
• Gonapeptyl Depot
• Ramipril capsules
• Ramipril tablets
SPC changes
• Zocor and myopathy
• Prozac licence
• Seroquel indication
Discontinued products
• Estrapak
• Lemsip Pharmacy Non-Decongestant
Supply problems
• Temazepam tablets
• Andropatch patches

Prescription Products

Gonapeptyl Depot
Ferring has launched Gonapeptyl Depot (triptorelin [as acetate]) pre-filled syringes containing 3.75mg of the gonadotrophin analogue triptorelin to be suspended in 1ml suspension agent. Net price; 1 syringe, £105.05. Legal category: POM.

Ramipril capsules
Ramipril capsules are now available from:

• APS/Berk; net price,1.25mg 28 £5.04, 2.5mg 28 £7.13, 5mg 28 £9.94, 10mg 28 £13.53.

• Sandoz; net price, 1.25mg 28 £5.30, 2.5mg 28 £7.51, 5mg 28 £10.46, 10mg 28 £14.24. Initial packaging consists of four blister strips of seven tablets, which will subsequently be changed to two strips of 14 capsules.

• Genus Pharmaceuticals; net price, 2.5mg 28 £7.51, 5mg 28 £10.46, 10mg 28 £14.24.

Ramipril tablets
Ramipril tablets are now available from APS/Berk; net price, 1.25mg 28 £5.04, 2.5mg 28 £7.13, 5mg 28 £9.94, 10mg 28 £13.53.

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SPC changes

Zocor and myopathy
The summary of product characteristics for Zocor (simvastatin) now states that the risk of myopathy/rhabdomyolysis is increased by concomitant administration of amiodarone or verapamil with higher doses of simvastatin (Merck Sharp & Dohme). It states that in patients taking amiodarone or verapamil concomitantly with simvastatin, the dose of simvastatin should not exceed 20mg a day unless the clinical benefit is likely to outweigh the increased risk of myopathy. The SPC now also states that patients on diltiazem treated concomitantly with simvastatin 80mg have a slightly increased risk of myopathy. See SPC.

Prozac licence
The summary of product characteristics for Prozac (fluoxetine hydrochloride) has been revised (Eli Lilly). Prozac is no longer licensed for the treatment of premenstrual dysphoric disorder. The dose range for depression has been extended from a starting dose of 20mg to up to 60mg a day. The SPC now states that fluoxetine can be used during pregnancy, but caution should be exercised since adverse effects have been reported in neonates. Further information has been included about fluoxetine dosing in obsessive-compulsive disorder and the elderly, and about use of monoamine oxidase inhibitors with fluoxetine. Warnings have been added about electroconvulsive therapy, St John’s wort and serotonin syndrome. See SPC.

Seroquel indication
Seroquel tablets (quetiapine) are now indicated for the treatment of manic episodes associated with bipolar disorder either as monotherapy or adjunct therapy (AstraZeneca). The total daily dose for the first four days of therapy is 100mg on day one, increasing by 100mg a day to 400mg on day four. Further dosage adjustments up to 800mg per day by day six should be in increments of no greater than 200mg per day. The usual effective dose is in the range of 400 to 800mg per day. A section on acute withdrawal reactions has also been added to the SPC and the pharmacokinetics and interactions sections have been updated. See SPC.

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Discontinued products

Estrapak
Estrapak (estradiol), containing hormone replacement patches and tablets, has been discontinued (Novartis).

Lemsip Pharmacy Non-Decongestant
Lemsip Pharmacy Non-Decongestant Formula sachets (paracetamol) are being discontinued with immediate effect (Reckitt Benckiser).

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Supply problems

Temazepam tablets
Alpharma packs of temazepam tablets 10mg x 28 and 20mg x 28 are currently out of stock. Bulk packs of 10mg x 500 and 20mg x 250 remain available.

Andropatch patches
There is currently a shortage of Andropatch (testosterone) transdermal patches 2.5mg and 5mg (GlaxoSmithKline). Local service providers have a small stock of both strength patches, and the UK distribution centre has a small stock of the 5mg patches. Stock for both strength patches will be available towards the end of February. Details from GSK on 0800 221 441.

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