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Managing interactions with direct oral anticoagulants (DOACs)

5 January 2024Interactions with apixaban, dabigatran, edoxaban or rivaroxaban can result in increased risks of a bleed or thrombosis. We advise on management options.

Understanding direct oral anticoagulant (DOAC) interactions

5 January 2024It is important to understand the risks, mechanisms of interactions and actions to take when prescribing medicines with DOACs.

Use of nefopam for chronic pain

5 January 2024Nefopam is licensed for chronic pain relief. However, evidence to support use is limited and is not included in national guidelines.

Managing interactions with methotrexate

28 December 2023Guidance on frequently asked questions on medicine interactions with low dose methotrexate.

Using metronidazole during breastfeeding

22 December 2023Metronidazole can be used during breastfeeding for most usual treatment courses. Recommendations apply to full term, healthy infants.

Using vitamin D during breastfeeding

8 December 2023Vitamin D can be used during breastfeeding; higher doses require infant monitoring. Recommendations apply to full term, healthy infants only.

Managing interactions between macrolides and statins

24 November 2023The use of statins can be continued with azithromycin. However, the interaction risks need to be managed if clarithromycin or erythromycin are required.

Implementing pharmacogenomic testing for aminoglycosides

24 November 2023Patients with mitochondrial variants have an increased risk of deafness with gentamicin, amikacin, tobramycin and neomycin. Guidance on testing is provided.

Using paracetamol during breastfeeding

21 November 2023Paracetamol is one of the analgesics of choice for treating mild to moderate pain during breastfeeding. Recommendations apply to full term and healthy infants.

Supporting system response to the ADHD medicine shortage

16 November 2023Practical advice for the system in response to the NatPSA for Attention Deficit Hyperactivity Disorder (ADHD) medicines.

SPS - Specialist Pharmacy Service

NHS