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Published: 3 June, 2022


Coeliac Awareness Week

Next week (6 – 12th June) is coeliac disease awareness week. The theme for this year is “Thriving: living your best coeliac life”. Click here for more information. Coeliac disease is a chronic inflammatory condition of the small intestine that causes villous atrophy and results in nutrient malabsorption. This condition occurs in genetically susceptible people and involves an autoimmune response to gluten – the major protein found in varieties of wheat, rye and barley. It is not an allergy to gluten. People with untreated coeliac disease have an increased risk of long-term health conditions such as osteoporosis, lymphoproliferative disorders and gastrointestinal malignancy.

Stay tuned for an upcoming article on coeliac disease from the bpacnz team

Antiviral treatment for COVID-19 – access criteria assessment tool

Last month, access criteria to COVID-19 antiviral treatments was widened. To make it easier for clinicians to assess a patient’s eligibility for funded treatment, PHARMAC has released an online tool, which helps users work through criteria 4 of the 5-part access criteria, i.e. the patient must also meet criteria 1, 2, 3 and 5 to be eligible for funded treatment. For some patients, you will still need to determine their eligibility based on the number of high-risk medical conditions they have – there is a link to this list within the tool

For further information, see:

Pharmacist prescribers can now prescribe antivirals

A number of COVID-19 medicines have been added to the schedule for pharmacist prescribers, including nirmatrelvir with ritonavir (Paxlovid), casirivimab and imdevimab (Ronapreve) and molnupiravir (Lagevrio). Widening the range of prescribers for antiviral medicines is expected to improve community access to COVID-19 treatments and enable timely access to treatment for people who are at risk of severe illness with COVID-19. Click here for more information.

Changes to liquid paracetamol

Changes to prescribing and dispensing - PHARMAC has advised that limits have been placed on the amount of oral liquid paracetamol that can be prescribed or dispensed. This action has been taken to ensure that there are sufficient supplies of the currently funded Paracare brand due to the supplier, API Consumer Brands, leaving the market and because there is still significant worldwide demand due to COVID-19.

From 1 June, 2022:

  • Stat dispensing for both strengths of the Paracare brands will be removed
  • The maximum amount able to be prescribed per prescription will be 600 mL. Patients who require regular daily dosing, e.g. those with long-term conditions can be prescribed more by endorsement.
  • The maximum amount able to be dispensed at one time (other than for patients with endorsement) will be 200 mL with repeat dispensing allowed if the amount prescribed exceeds this limit.

Brand and pack size changes – PHARMAC has secured ongoing supply of liquid paracetamol but it will mean that the brand and pack sizes will change. The new brands will have the same flavours as the current funded brands, however, they will only come in 200 mL bottles.

The upcoming changes are:

  • From 1 November, 2022, the funded brand of paracetamol 250 mg per 5 mL oral liquid will be Pamol
  • From 1 January, 2023, the funded brand of paracetamol 120 mg per 5 mL oral liquid will be Paracetamol (Ethics)

Infant formula recall

The Ministry for Primary Industries has issued a safety notice about three brands of infant formula. Similac, Alimentum and EleCare brands of powdered infant formula are being recalled over concerns for the possible presence of Cronobacter. These brands are not available for purchase in New Zealand, however, they can be purchased from online platforms. Encourage parents or caregivers who source their infant formula online to check the batch information.

N.B. EleCare is funded in New Zealand but is currently out of stock and batches sourced via a prescription through a pharmacy are not affected.

On another note, infant formula shortages continue to be reported internationally due to manufacturing issues and recalls. Stocks of most brands of infant formula in New Zealand are currently unaffected, however, general measures such as not stockpiling and only prescribing in appropriate quantities, should continue. N.B. There are still ongoing Nutricia supply issues affecting some products such as extensively hydrolysed formula. You can keep up to date with the latest medicine supply issues here.

Updated guidance on doctor to doctor complaints

The Medical Council of New Zealand has released updated guidance on what to do when you have concerns about another doctor’s conduct, performance, competence or health. The guidance sets out a tiered approach and recommends that the concern be raised directly with the doctor in the first instance, if appropriate. It also addresses how to raise a concern about another health professional who is not a doctor.

Key points include:

  • Find out the facts without delaying the issue to minimise the risk of harm to the patient
  • Raise concerns directly with the doctor (if appropriate) and document your actions and the doctor’s response
  • Follow your organisation’s procedure for reporting concerns if the matter requires escalation
  • Notify Te Kaunihera Rata o Aotearoa I Medical Council of New Zealand as appropriate, i.e. if you remain concerned that the conduct, competence or health of the doctor might pose a risk of harm
  • Notify the Health and Disability Commissioner if you have concerns about the standard of care another doctor has provided to a patient

Read the full statement here

NZF updates for June

Significant changes to the NZF in the June, 2022, release include:

  • Type 1 diabetes (high risk of diabetic ketoacidosis) has been added as a contra-indication for empagliflozin and empagliflozin + metformin hydrochloride
  • A new caution, serotonin syndrome, has been added to the monograph for phentermine. There is potential risk for serotonin syndrome with concomitant use of other serotonergic medicines.
  • The monograph for testosterone and esters has been updated, e.g. updated contra-indications, pre-treatment screening, monitoring requirements and patient advice. N.B. Testosterone cypionate 1 g/10 mL injections are out of stock until September, 2022.
  • New patient information leaflets have been added for adapalene, pioglitazone, remdesivir and rosuvastatin
  • Health Navigator leaflets in English, Te reo Māori, Samoan, Tongan, Cook Islands Māori and Niuean have been added for paracetamol and Paxlovid (nirmatrelvir with ritonavir). Chinese (simplified) has also been added for Paxlovid.

Paper of the Week: Monkeypox – the latest virus to surface

This week it is not “paper of the week”, more a look at the “virus of the week”. With various reports about monkeypox circulating in the media and growing case numbers worldwide, we thought that it would be interesting and potentially helpful to provide a general overview and some background on this zoonotic virus. With recent reports of up to five cases in Australia, sooner or later, we may see a case here.

This Bulletin is supported by the South Link Education Trust

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