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Published: 2 October, 2020


BPJ is back!

We hope that you enjoyed reading our commemorative digital edition of Best Practice Journal, containing a curated collection of our most popular articles from the last few years. Congratulations to those of you who were lightening quick enough to secure a printed copy – we "sold out" of our 400 copies in just over six hours! The good news is that there is still plenty of time to enter our competition to win an iPad. If you haven't done so already, we would love for you to take a look:

Reminder: Updated National Immunisation Schedule from 1 October, 2020

As reported in previous bulletins, a new vaccination event for children aged 12 months has been added to the National Immunisation Schedule as of 1 October, 2020. The Immunisation Handbook has been updated to reflect all the changes and the 2020 edition is now available online and to download.

IM route of administration now recommended for live vaccines

The Ministry of Health has updated its advice in the 2020 Immunisation Handbook regarding the preferred route of administration for live vaccines such as MMR, varicella and herpes zoster (shingles): live vaccines should be given by the intramuscular (IM) route (except if there is a bleeding risk – see below).

Medicine supply updates:

Latest medicine supply/discontinuation issues are listed on the PHARMAC website here.

Supply issue with ipratropium bromide and salbutamol inhaler (Duolin)

The supplier of Duolin, the combination inhaler containing 20 micrograms of ipratropium bromide and 100 micrograms of salbutamol, has notified PHARMAC that this inhaler is now out of stock.

Cilazapril (Zapril) 5 mg dispensed monthly from 1 October, 2020

Due to a potential supply issue with the 5 mg strength of the funded brand of cilapril (Zapril), PHARMAC has advised that all-at-once (three-monthly) dispensing has been removed from 1 October, 2020 to maintain continuity of supply for this dose formulation. Supply of the 2.5 mg strength is not currently affected.

Terazosin to be discontinued

PHARMAC has announced that terazosin, an alpha-adrenoceptor blocker prescribed to men with benign prostatic hyperplasia, will be discontinued during 2021 with stock anticipated to run out around May, 2021. This is due to supply issues with the current funded brand (Apo-Terazosin) and a lack of success in sourcing another brand for long-term supply. Those currently taking terazosin need to be transitioned to a different treatment and no new patients should be started on terazosin.

Oestradiol patches: 50 microgram patch now also in short supply

In Bulletin 9 we reported that stock of 25 microgram oestradiol patches was depleted. PHARMAC has updated this information to advise that 50 microgram patches are now also in short supply. An alternative brand of 50 microgram patches, Climara, has been able to be sourced, however, note that Climara patches are applied once weekly (i.e. every seven days), whereas the original funded brand, Estradot, are applied twice weekly (i.e. every three to four days). It is anticipated that Estradot 50 mcg patches will be back in stock by mid-October and 25 mcg patches by the end of October, 2020.

For further information on the role of oestradiol patches and other treatments for menopausal symptoms, see

Happy 100th New Zealand Formulary

We would like to congratulate our colleagues at the New Zealand Formulary (NZF) for the publication this month of their 100th monthly release of the NZF. The NZF was first published in 2012, followed by the NZF for Children in 2013. The NZF is provided online, free of charge, to all healthcare professionals prescribing, dispensing and administering medicines across community and hospital care.

Paper of the week: What happened to evidence-based medicine? An opinion piece

Dr Margaret McCartney is a general practitioner from Glasgow, Scotland. She is known for her pragmatic views and insightful commentary. We have enjoyed many columns that she has written, and wanted to share with you a short opinion piece she wrote recently about the demise of evidence-based medicine during the COVID-19 pandemic.

"When Donald Trump said that he had a ‘good feeling’ about hydroxychloroquine in the treatment of COVID-19, I had a bad feeling..."

Read Dr McCartney's article here

This Bulletin is supported by the South Link Education Trust

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