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Medicine indications

Benzodiazepines and zopiclone: is overuse still an issue?

Despite being recommended for short-term use only, and usually second-line to non-pharmacological management strategies, benzodiazepines... View Article

February 2021

Limiting the use of quinolone antibiotics

Quinolones (e.g. ciprofloxacin, norfloxacin) are associated with increasing antimicrobial resistance and rare, but potentially... View Article

February 2021

Withdrawing patients from long-term use of benzodiazepines or zopiclone

Stopping benzodiazepine or zopiclone treatment in people who have been taking these medicines long-term can be challenging. Strategies... View Article

February 2021

The COPD prescribing tool for initiating medicines

This tool provides pharmacological treatment options for patients with COPD based on their symptom severity. Choose category... View Article

June 2020

Vildagliptin: a new treatment for type 2 diabetes

Vildagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor available fully subsidised from 1 October, 2018. DPP-4 inhibitors have... View Article

September 2018

Prescribing ACE inhibitors: time to reconsider old habits

Prescribers in New Zealand are highly reliant on cilazapril as their “go-to” ACE inhibitor, but this prescribing is out of step... View Article

September 2018

Rivaroxaban: a fully-subsidised oral anticoagulant

From 1 August, 2018, rivaroxaban will be fully subsidised without restriction for people who require an oral anticoagulant. This... View Article

July 2018

Selected topics in acute pain management for primary care

There are a multitude of causes of acute pain, however, the approach to management will often be similar; assessment guides prescribing... View Article

February 2018

Prescribing tramadol appropriately

Tramadol is an atypical opioid used for moderate pain when paracetamol and/or a NSAID is not adequate. There is no evidence that... View Article

February 2018

When to consider strong opioids for patients with acute pain

There are few indications for prescribing a strong opioid for acute pain in a primary care setting. If a strong opioid is required,... View Article

February 2018

Celecoxib: the “need to know” for safe prescribing

Celecoxib is a selective cyclo-oxygenase-2 (COX-2) inhibitor that has been fully subsidised without restriction, since 1 June,... View Article

January 2018

Intravenous ferric carboxymaltose: now available for the treatment of iron deficiency

Intravenous ferric carboxymaltose is now a potential option for treating patients with iron deficiency anaemia in the community.... View Article

November 2017

Beta-blockers for cardiovascular conditions: one size does not fit all patients

Metoprolol succinate accounts for almost three-quarters of the beta-blockers dispensed in New Zealand. There is, however, little... View Article

July 2017

Amiodarone brand-change and a reminder on patient monitoring

The funded brand of amiodarone has now changed, see: Antiarrhythmic medicine brand changes: flecainide and amiodaroneTwo brands... View Article

October 2016

Oxycodone prescribing: New Zealand solutions to a global problem

Inappropriate prescribing of opioids for non-cancer pain is an international problem. In this article we examine an initiative... View Article

October 2016

Vitamin D

This report provides data on the use of vitamin D supplementation over the 12 month period from July, 2015 to June, 2016. View Article

September 2016

Vitamin D and calcium supplementation in primary care: an update

In 2011, bpacnz produced guidance on vitamin D supplementation for primary care. In the past five years vitamin D use has... View Article

August 2016

Upfront: Tips for prescribing newly-subsidised medicines for patients with COPD

In March, 2016, subsidy changes came into effect for medicines used to treat patients with COPD. The large number of changes created... View Article

August 2016

The COPD prescribing tool

This tool provides pharmacological treatment options for patients with COPD based on their symptom severity. Choose category... View Article

July 2016

Polypharmacy Update

This report provides prescribers with details about patients in their practice who are taking ten or more medicines over a 12... View Article

July 2016

Medicine use in youth mental health

This report provides an overview of dispensings of medicines indicated for the treatment of depression and anxiety in patients... View Article

April 2016

Newly-subsidised medicines for the treatment of patients with COPD

Subsidy changes for medicines used to treat patients with COPD came into effect on March 1, 2016. In this article we discuss how... View Article

March 2016

Valaciclovir – a first line antiviral medicine

Valaciclovir is an antiviral medicine which can be used for the treatment of Herpes simplex infections and herpes zoster. As of... View Article

March 2016

Oxycodone Update

This report provides an update on the use of oxycodone over the 12 month period from October, 2014 – September, 2015. View Article

March 2016

Biosimilars - what does a primary care clinician need to know?

”Biosimilars” is likely to become an increasingly familiar term for clinicians in New Zealand and worldwide. Medicines produced... View Article

October 2015

Melatonin: is it worth losing any sleep over?

Modified-release melatonin is an unsubsidised medicine that is approved for, and moderately effective at, improving sleep quality... View Article

August 2015

Use of Hypnotics

Zopiclone and some benzodiazepines, such as temazepam and triazolam, are indicated for the short-term treatment of insomnia. View Article

May 2015

News Update

Brand changes for cardiovascular medicines: carvedilol, ezetimibe and ezetimibe with simvastatin View Article

April 2015

An update on antithrombotic medicines - What does primary care need to know?

Antithrombotic medicines, such as aspirin and warfarin, have been routinely prescribed in primary care for decades for the prevention... View Article

April 2015

Dabigatran - An Update

This report provides an update on the use and monitoring of dabigatran between October, 2013 and September, 2014 in general practice... View Article

March 2015

Overuse of benzodiazepines: still an issue?

Benzodiazepines may be considered as a short-term treatment for insomnia and anxiety; zopiclone, a benzodiazepine-like medicine,... View Article

March 2015

Research updates

Shorter courses of oral corticosteroids for the management of exacerbations in patients with COPD | Diet and the risk of COPD View Article

March 2015

2014 Annual Practice Report - Pharmaceutical and Laboratory Test Utilisation

This report has been developed to give you an opportunity to reflect on the treatment received by patients registered at your... View Article

December 2014

An update on bisphosphonates

This report provides an update on the use of bisphosphonates in New Zealand. In the past year changes to funding occurred, including... View Article

November 2014


Polypharmacy is a marker of potential problematic prescribing. In clinical practice, defining polypharmacy purely by a specific... View Article

November 2014

Polypharmacy in primary care: Managing a clinical conundrum

Polypharmacy can be appropriate and beneficial for patients. However, polypharmacy also increases the risk of problematic prescribing... View Article

October 2014

Topical antibiotics: very few indications for use

Topical antibiotics in general have been excessively used in New Zealand in recent years. The increasing prevalence of resistance... View Article

October 2014

News Updates

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

October 2014

News Updates

Does aspirin protect against cancer? More high-quality research is needed View Article

September 2014

Safer prescribing of high-risk medicines: Colchicine – extremely toxic in overdose

Colchicine is a plant-based alkaloid, extracted from Colchicum autumnale (autumn crocus, meadow saffron) and Gloriosa superba... View Article

September 2014

Oxycodone Update

Since 2011, bpacnz has produced a series of reports and articles on appropriate use of opioids and has urged prescribers to review... View Article

August 2014

Oxycodone: how did we get here and how do we fix it?

Following on from the interview with Dr Jeremy McMinn in the last edition of Best Practice Journal, we examine in more detail... View Article

July 2014

Safer prescribing of high-risk medicines: Clozapine

Pharmacological treatment is an integral part of the practice of medicine, and is one of the most significant factors in improving... View Article

July 2014

The role of triptans in the treatment of migraine in adults

Paracetamol or a non-steroidal anti-inflammatory drug (NSAID) can be used first-line for pain relief in acute migraine. A triptan... View Article

July 2014

News Updates

Evidence that alternate dosing of paracetamol and ibuprofen in children with fever may reduce temperature: other benefits un... View Article

July 2014

Gout update: Febuxostat now subsidised on Special Authority

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

July 2014

News Updates

Reminder: Most broad-spectrum antibiotics do not interact with combined oral contraceptives | Oseltamivir (Tamiflu) and Zanamivir... View Article

June 2014

News Updates

Simvastatin and atorvastatin: beware of potential CYP3A4 interactions when prescribing other medicines View Article

April 2014

Managing patients with dementia: What is the role of antipsychotics?

Concerns have been raised, both in New Zealand and internationally, about the increasing off-label use of antipsychotics, and... View Article

December 2013

Biologic medicines for the treatment of inflammatory conditions: What does primary care need to know?

Patients with severe immune-mediated inflammatory diseases, e.g. rheumatoid arthritis, Crohn’s disease or psoriasis, often respond... View Article

December 2013

The use of omeprazole in infants is still high

Omeprazole is not approved for use in infants (children aged under one year). Although omeprazole is effective at reducing gastric... View Article

December 2013

2013 Annual Practice Report - Pharmaceutical and Laboratory Test Utilisation

This report has been developed to give you an opportunity to reflect on the treatment received by patients registered at your... View Article

November 2013

Risedronate now fully subsidised: What is its place in practice?

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

November 2013

Prescribing update: Low dose isotretinoin for acne?

New evidence is increasingly suggesting that isotretinoin may be best prescribed using a lower daily dose, with the regimen tailored... View Article

November 2013

Non-steroidal anti-inflammatory drugs (NSAIDs): Making safer treatment choices

Non-steroidal anti-inflammatory drugs (NSAIDs) are successfully used to treat a wide range of painful conditions. However, NSAIDs... View Article

October 2013

Appropriate use of amoxicillin clavulanate

Amoxicillin clavulanate is a broad spectrum antibiotic which is used frequently in New Zealand general practice. The proportion... View Article

August 2013

Ticagrelor – out with the old, in with the new?

Ticagrelor (Brilinta) is a new oral antiplatelet medicine, which has been available, fully subsidised, with Special Authority,... View Article

August 2013

Dabigatran in general practice

Dabigatran is an oral anticoagulant approved for use in non-valvular atrial fibrillation and prevention of venous thromboembolism... View Article

March 2013

Upfront: Unapproved medicines and unapproved uses of medicines: keeping prescribers and patients safe

An approved medicine is a medicine which has been through a regulatory process in New Zealand and can be considered safe to prescribe,... View Article

March 2013

Dabigatran revisited

Dabigatran has been available for general practitioners to prescribe since July, 2011. Dabigatran is indicated for prevention... View Article

February 2013

Appropriate use of sulfonamides

What are sulfonamides and how do they work? | Prescribing co-trimoxazole | Adverse effects of co-trimoxazole | Medicine interactions... View Article

December 2012

2012 Annual Report - Pharmaceutical & Laboratory Test Utilisation

Welcome to your annual practice report This report has been developed to give you an opportunity to reflect on the treatment received... View Article

November 2012

News and updates: Update on azithromycin

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

November 2012

When and how to use a syringe driver in palliative care

Syringe drivers are often required to provide medicines for symptom management in patients who are terminally ill. They provide... View Article

November 2012

Appropriate use of tetracyclines

What are tetracyclines and how do they work? | Which infections should tetracyclines be used for? | First-line indications for... View Article

October 2012

The appropriate use of macrolides

Macrolides are a class of antibiotic that includes erythromycin, roxithromycin, azithromycin and clarithromycin. First-line indications... View Article

May 2012

Appropriate use of metronidazole

How does metronidazole work? | Which infections should metronidazole be used for? | First line indications for metronidazole... View Article

April 2012

Looking back, looking forward: key messages 2005 – 2011

This report highlights four key prescribing and laboratory testing recommendations covered over the past five years. Over this... View Article

March 2012

Initiating insulin for people with type 2 diabetes

Due to its progressive nature, many people with type 2 diabetes will eventually require insulin treatment. Insulin initiation... View Article

February 2012

Prescribing atypical antipsychotics in general practice

The use of atypical antipsychotics such as quetiapine and olanzapine is increasing. In many cases, these medicines are used for... View Article

November 2011

The use of dabigatran in general practice

Dabigatran (Pradaxa) is now available in New Zealand, fully funded, without Special Authority, as an alternative oral anticoagulant... View Article

September 2011

Medicine safety

Dr Janice Wilson, Health Quality & Safety Commission's Chief Executive, says medicine errors are an ongoing and potentially serious... View Article

September 2011

Appropriate use of amoxicillin clavulanate

Amoxicillin clavulanate is an important and effective medicine but its use must be reserved for specific indications in order... View Article

September 2011

Community-based IV administration: primary care reducing hospital admissions

Intravenous (IV) administration of medicines in general practice clinics or in patient’s homes, is becoming increasingly common... View Article

September 2011

2011 Annual Report
Pharmaceutical & Laboratory Test Utilisation

This web version is a sample only, all data below the national level has been omitted. View Article

September 2011

Management of depression in older people

Older people respond well to treatments for depression. The management of depression in older people essentially follows the same... View Article

July 2011

Oxycodone Prescribing

Examines oxycodone prescribing compared to that of morphine. View Article

June 2011

Vitamin D supplementation: Navigating the debate

Despite the increasing focus on vitamin D levels and claimed associations with many health conditions, there is no evidence to... View Article

June 2011

Quinolone antibiotics - limit use

Quinolones are associated with increasing antimicrobial resistance. Their use needs to be reserved for specific indications involving... View Article

April 2011

Contraception in early adolescence

Young people are having sex. Advice about sexual health and contraception should be considered for all adolescents, including... View Article

April 2011

News in brief

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

February 2011

Snippets: Fentanyl patches

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

December 2010

Snippets: Jadelle & Sibutramine

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

November 2010

Snippets: Insulin glargine & Ezetimibe

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

October 2010

Which Antihypertensive?

Once the decision has been made to initiate antihypertensive treatment, choice of medicine should be based on individual patient... View Article

October 2010

Access to clopidogrel now widened

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

October 2010

ANTIMICROBIALS how should they be used in primary care?

Ideally antibiotics should be reserved for the treatment of known bacterial infection but it is well recognised that they are... View Article

October 2010

An update on statins

The decision to initiate a statin should be based upon an individual’s risk of cardiovascular disease (CVD), the likely... View Article

August 2010

The pharmacological management of Alzheimer’s disease: The place of donepezil

From November 1, 2010 donepezil will be funded without Special Authority, on the Pharmaceutical Schedule. Donepezil and other... View Article

August 2010

Do cough and cold medicines work in children?

The short answer is no. There is little evidence that cough and cold preparations have any clinically significant effect on reducing... View Article

July 2010

Snippets: Gabapentin Humalog & Tramadol

Humalog, Tramadol and Gabapentin View Article

June 2010

Medicines for weight loss - do they work

A more recent article has been published on this subject: Weight loss: the options and the evidence Improving diet and increasing... View Article

April 2010

Low molecular weight heparin use in primary care

Enoxaparin (Clexane) is a low molecular weight heparin used in the treatment of acute coronary syndromes and in the treatment... View Article

November 2009

Oxycodone: place in therapy

Oxycodone is a strong opiod and is a second line option (after Morphine) for use at step three on the WHO analgesic ladder. It... View Article

November 2009

Topical corticosteroid treatment for skin conditions

Topical corticosteroids are used to treat many skin conditions. They should be used at the lowest potency possible for the shortest... View Article

September 2009

Pharmacological Management of Depression in Adults

All antidepressant drugs are approximately equal in effectiveness, although individual patient response may vary markedly.10 View Article

July 2009

Selected topics in asthma

Intermittent or persistent asthma? Which inhaled corticosteroid? The role of long acting beta-2 agonists (LABA). Role of nebulisers... View Article

May 2009

Smoking cessation - Pharmacological therapy

Nicotine replacement therapy, nortriptyline, bupropion and varenicline are all effective aids for smoking cessation. These pharmacological... View Article

April 2009

The use of insulin in type 2 diabetes

There is evidence that early use of insulin in people with type 2 diabetes is beneficial. At present insulin is under used in... View Article

April 2009

Getting the most out of nicotine replacement therapy

Nicotine replacement therapy (NRT) is not a magic cure but it is effective for smoking cessation when used correctly. It is important... View Article

April 2009

Warfarin vs. aspirin for the prevention of atrial fibrillation related stroke

The decision whether to choose aspirin or warfarin for stroke prevention is often not clear cut. There is evidence that treatment... View Article

February 2009

The role of antiplatelet agents

Antiplatelet drugs including aspirin, clopidogrel and dipyrimadole, reduce the incidence of cardiovascular events by about 20-25%... View Article

February 2009

WHO Analgesic Ladder: which opioid to use at step two?

There are several different opioid options that can be considered at step two of the WHO analgesic ladder for chronic pain. Choice... View Article

December 2008

Safe Prescribing of Morphine in Primary Care

Advice from the 'Safe and Quality Use of Medicines Group'. View Article

October 2008

Widened access to fentanyl patches

Fentanyl is a synthetic opioid which is available as a transdermal patch. This allows controlled delivery of the drug for up to... View Article

September 2008

Imiquimod cream (Aldara) for genital warts and basal cell carcinoma

Imiquimod enhances the immune response to viral infections and tumours by stimulating the immune system to release interferon... View Article

September 2008

Using nebulisers safely

Nebulisers are used to deliver bronchodilators to people with asthma or COPD or antibiotics to those with bronchiectasis. There... View Article

August 2008

Dilemmas: Managing cardiovascular risk in elderly people

Older people have a higher cardiovascular risk and therefore appear to have the most potential to benefit from risk reduction,... View Article

February 2008

GP guide to some topical eye treatments

Some eye medications are used when there is high risk of visual loss and their misuse can increase this risk. Initiation and... View Article

December 2007

Role of calcium channel blockers in hypertension

Thiazides are considered to be appropriate initial treatment for most people with hypertension. Choice of other antihypertensives,... View Article

December 2007

Upfront: co-enzyme Q10 supplements

“Would you like fries with that”. The role of co-enzyme Q10 supplements in medical treatment. View Article

September 2007

Is carvedilol superior to metoprolol in heart failure?

Carvedilol may be an option for patients initiating beta-blocker treatment for heart failure or patients in whom metoprolol is... View Article

September 2007

Dear Dave

Can Sumatriptan be used safely with SSRIs? Can you ever use beta-blockers in someone with a history of Asthma? View Article

August 2007

Upfront: The Augmentin-free office

Practical advice on reducing the use of augmentin View Article

August 2007

Safe use of paracetamol in children

The evidence-base for the information contained in this article is no longer current: please refer to the New Zealand Formulary... View Article

May 2007

Over-the-counter medication in children: friend or foe?

The information in this article is now out of date. An updated article can be found here: http://www.bpac.org.nz/BPJ/2010/July/coldmeds.aspx A... View Article

May 2007

Herceptin the facts

A focus on the clinical issues surrounding the use of Herceptin including latest results from clinical trials. View Article

April 2007

Key messages on the use of SSRIs

Key messages on the use of SSRIs. View Article

March 2007

Dear Dave

Can smoking cessation affect the dose of antipsychotics?Do statins cause nightmares?How important is it to give simvastatin at... View Article

February 2007

Lithium in General Practice

In this article we provide an overview and guidance on the management of patients taking lithium. View Article

February 2007

TCAs are useful for depression and neuropathic pain

Tricyclic antidepressants (TCAs) are an effective alternative to selective serotonin re-uptake inhibitors (SSRIs) in the treatment... View Article

December 2006

Update on the use of LABAs for the treatment of Asthma

Long acting beta agonists (LABAs) are useful drugs in asthma management however they should only be prescribed for patients who... View Article

December 2006


An update on treatment of atrial fibrillation with a focus on warfarin. View Article

December 2006

COPD update

Tiotropium is an effective option | Long acting beta agonists | Inhaled corticosteroids | Exercise | Should an anticholinergic... View Article

October 2006

Dear Dave

Is it safe to use beta-blockers for cardiac disease in people with COPD? View Article

October 2006

Depression antidepressant update

Venlafaxine: how and when to use | Antidepressants for elderly people | Antidepressants in pregnancy and breastfeeding | Suicide... View Article

October 2006

NSAIDs and coxibs

Cardiovascular risk associated with NSAIDs and coxibsNSAIDs in the treatment of soft tissue injuries View Article

October 2006

Appropriate use of cephalosporins

There are very few indications for the use of cephalosporins as first-line antibiotic treatment. Ceftriaxone is used for the treatment... View Article

December 2011