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PJ Online homeThe Pharmaceutical Journal
Vol 272 No 7304 p763
19 June 2004

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Products

    Prescription Products SPC changes Discontinued products Supply issues

Recall Methotrexate tablets 10mg


Prescription Products

Strattera
Composition: atomoxetine hydrochloride.
Presentation: hard capsules.
Action: selective inhibitor of the pre-synaptic noradrenaline transporter.
Indications: treatment of attention-deficit/hyperactivity disorder (ADHD) in children six years of age and older, adolescents and adults.
Dosage: children and adolescents up to 70kg body weight: initiation dose approximately 0.5mg/kg per day, recommended maintenance dose approximately 1.2mg/kg per day. Children and adolescents over 70kg body weight and adults: initiation dose 40mg per day, recommended maintenance dose 80mg per day.
Cautions: atomoxetine should be used with caution in patients with hypertension, tachycardia or cardiovascular or cerebrovascular disease. Growth should be monitored during treatment. Atomoxetine may exacerbate hypertension in patients with end stage renal failure. Doses should be reduced in those with moderate hepatic insufficiency. See SPC.
Contraindications: atomoxetine should not be used in combination with monoamine oxidase inhibitors. Not recommended in patients with narrow angle glaucoma.
Side effects: abdominal pain, decreased appetite.
Net price: 7 (10mg, 18mg, 25mg or 40mg) £13.65 , 28 (10mg, 18mg, 25mg, 40mg or 60mg) £54.60.
Contact details: Eli Lilly & Co, Lilly House, Priestly Road, Basingstoke, Hampshire RG24 9NL (tel 01256 315999).
Strattera will be available to order from 7 July.

Levemir
Composition: insulin detemir 100U/ml.
Presentation: solution for injection in cartridges (Penfill) and pre-filled pens (FlexPen).
Class: long-acting human insulin analogue.
Indications: treatment of diabetes mellitus.
Dosage: adjusted individually and administered by subcutaneous injection once or twice daily in combination with meal-related short- or rapid-acting insulin.
Precautions: Mixing of rapid acting insulin with Levemir should be avoided. Patients taking Levemir may require a change in dosage from that used with their usual insulin. Transferring a patient to another type of insulin should be done under strict medical supervision.
Net price: 5x3ml pack of either presentation £39.
Contact details: Novo Nordisk, Broadfield Park, Brighton Road, Crawley, West Sussex RH11 9RT (tel 01293 613555).
Levemir will be available to order from 21 June.

Imigran Radis
Imigran (sumatriptan succinate) Radis, rapidly disintegrating tablets have been launched (GlaxoSmithKline). Net price 50mg 6 £26.74, 50mg 12 £53.52, 100mg 6 £48, 100mg 12 £96.

GONAL-f prefilled pen
GONAL-f (follitropin alfa) is now available as a prefilled pen (Serono). Net price 1 pen, 300IU/ 0.5ml £114.28, 450IU/0.75ml £171.42, 900IU/1.5ml £342.84.

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SPC changes

Crestor
The summary of product characteristics for Crestor (rosuvastatin) has been updated (AstraZeneca). It now states that the recommended start dose is 10mg daily, including for patients who are switched from another HMG-CoA reductase inhibitor. Effects on skeletal muscle have been reported in rosuvastatin-treated patients with all doses and in particular with doses of more than 20mg. Specialist supervision is recommended when the 40mg dose is initiated. The SPC states that the 40mg dose is contraindicated in patients with moderate or severe renal impairment, in Japanese and Chinese patients, with concomitant use of a fibrate and in patients with other predisposing factors for myopathy or rhabdomyolysis such as hypothyroidism. See SPC.

Zestril
The usual recommended starting dose for Zestril (lisinopril) in hypertension has increased from 2.5mg to 10mg daily (AstraZeneca). The SPC now states that patients with a strongly activated renin-angiotensin-aldosterone system (in particular, renovascular hypertension, salt and/or volume depletion, cardiac decompensation or severe hypertension) may experience an excessive blood pressure fall following the initial dose. A starting dose of 2.5–5mg is recommended in such patients and the initiation of treatment should take place under medical supervision. A lower starting dose is required in the presence of renal impairment. See SPC.

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Discontinued products

Flutamide tablets
Flutamide tablets 250mg have been discontinued from the Alpharma range.

Livostin eye-drops
Livostin (levocabastine hydrochloride) eye-drops have been discontinued (Novartis). Livostin nasal spray remains available.

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Supply issues

Eskamel cream
Eskamel (resorcinol and sulphur) cream 25g is back in stock (Goldshield) and is available from local wholesalers or from Health Care Logistics (tel 01753 650099, fax 01753 654455).

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