August 2022

New Products

• Bilastine (Allertine) is a non-sedating, long-acting histamine antagonist with selective peripheral H₁-receptor antagonist affinity and no affinity for muscarinic receptors. Allertine is indicated for the symptomatic treatment of allergic rhinoconjunctivitis (both seasonal allergic rhinitis and perennial allergic rhinitis) and/or urticaria. Allertine tablets contain bilastine 20 mg and are available in packs of 10 or 30.
   
• Diroximel fumarate (Vumerity) reduces inflammatory responses in both peripheral and central cells and promotes cytoprotection of central nervous system cells against toxic oxidative damage, demonstrating effects on pathways known to exacerbate multiple sclerosis (MS) pathology. Preclinical studies indicate that diroximel fumarate pharmacodynamic responses appear to be mediated, at least in part, through activation of the Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) transcriptional pathway, which is the primary cellular defense system for responding to a variety of potentially toxic stimuli through up-regulation of antioxidant response genes. However, the mechanism by which diroximel fumarate exerts therapeutic effects in MS is not fully understood. Vumerity is indicated in patients with relapsing MS to reduce the frequency of relapses and to delay the progression of disability. Vumerity is contraindicated in patients with known hypersensitivity to other fumaric acid derivatives and in suspected or confirmed progressive multifocal leukoencephalopathy. Vumerity capsules contain diroximel fumarate 231 mg and are available in packs of 120.
   
• Somatrogon (Ngenla) binds to the growth hormone (GH) receptor and initiates a signal transduction cascade culminating in changes in growth and metabolism. Consistent with GH signalling, somatrogon binding leads to activation of the STAT5b signalling pathway and increases the serum concentration of Insulin-like Growth Factor (IGF-1). IGF-1 was found to increase in a dose-dependent manner during treatment with somatrogon partially mediating the clinical effect. As a result, GH and IGF-1 stimulate metabolic changes, linear growth, and enhance growth velocity in paediatric patients with GH deficiency. Ngenla is indicated for the long-term treatment of paediatric patients with growth disturbance due to insufficient secretion of growth hormone. Ngenla is contraindicated in patients with active malignancy; or acute critical illness due to complications following open heart or abdominal surgery, multiple accidental trauma or acute respiratory failure. Ngenla solution for injection contains somatrogon 24 mg/1.2 mL or 60 mg/1.2 mL and is available in pack sizes of one 1.2 mL prefilled pen.
   
• Tepotinib (hydrochloride monohydrate) (Tepmetko) is a Type I adenosine triphosphate (ATP)‑competitive small molecule inhibitor of mesenchymal-epithelial transition (MET). Tepotinib inhibits HGF-dependent and independent MET phosphorylation and MET-dependent downstream signalling including the phosphatidylinositol 3-kinase/protein kinase B and mitogen-activated protein kinase/extracellular-signal regulated kinase pathways in a dose-dependent manner. Tepmetko has provisional approval for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer harbouring MET exon 14 skipping alterations. Tepmetko tablets contain tepotinib 225 mg and are available in a pack size of 60.

New Contraindications

• Acetazolamide (Diamox) is now contraindicated in severe glaucoma due to peripheral anterior synechia and haemorrhagic glaucoma.
   
• Disulfiram (Antabuse) is now contraindicated in uncompensated cardiac failure, serious organic brain damage and previous history of cerebrovascular accident.
   
• Esomeprazole magnesium trihydrate and amoxicillin trihydrate and clarithromycin (Nexium Hp7) is now contraindicated in hypomagnesaemia and with concomitant lomitapide.
   
• Isosorbide dinitrate (Isordil) is now contraindicated in acute circulatory failure (shock, vascular collapse); and aortic/mitral valve stenosis and disease associated with a raised intracranial pressure e.g. following a head trauma and including cerebral haemorrhage.
   
• Nirmatrelvir and ritonavir (Paxlovid) is now contraindicated with concomitant triazolam.

This list is a summary of only some of the changes that have occurred over the last month.
Before prescribing, always refer to the full product information.