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Published: 26 June, 2020


Top 10 bpacnz articles

Our ten most viewed resources by website users in New Zealand over the last 12 months were:

  1. Antibiotics guide
  2. Contraception series
  3. Primary care update series
  4. COPD prescribing tool
  5. Melatonin: is it worth losing any sleep over?
  6. Vildagliptin: a new treatment for type 2 diabetes
  7. A rising tide of diabetes in younger people: what can primary care do?
  8. What's new in cardiovascular disease risk assessment and management for primary care clinicians
  9. Weight loss: the options and the evidence
  10. Topical antibiotics for skin infections: when are they appropriate?

COVID-19 case definition updated

The Ministry of Health has updated the case definition for testing for COVID-19 infection. People who are symptomatic and meet the criteria for a "Higher Index of Suspicion (HIS)" are prioritised for testing, e.g. recent international travel, contact with a probable or confirmed case, worker at international airport. Other people presenting to primary care with symptoms consistent with COVID-19 should be encouraged to be tested even if they don't meet the HIS criteria.

A Ministry of Health COVID-19 information page for primary care, including a quick reference guide to the latest changes, is available here.

New asthma guidelines published

The Asthma + Respiratory Foundation NZ guidelines for the management of adults and adolescents with asthma have just been published today in the New Zealand Medical Journal. These guidelines, along with the newly updated asthma management in children guidelines, are also available on the Respiratory Foundation website.

bpacnz will be publishing articles on these new guidelines within the next few weeks.

Fluoxetine brand change

The funded brand of fluoxetine is changing from Arrow-Fluoxetine to Fluox (both are generic brands):

  • June, 2020 - Fluox 20 mg dispersible tablets available
  • September, 2020 - Fluox 20 mg capsules available

Stock of dispersible tablets has been low. Stock shortages of fluoxetine capsules earlier in 2020 caused an increase in demand for tablets. As a result, stocks of the Arrow-Fluoxetine dispersible tablet have been low. PHARMAC reports that the Fluox brand of dispersible tablet is now being distributed to pharmacies, therefore resolving the stock issue.

Supply of fluoxetine 20 mg capsules is available. Arrow-Fluoxetine is expected to be supplied until approximately September, 2020 when the Fluox brand becomes available.

N.B. Ideally, fluoxetine tablets should only be prescribed to patients who cannot swallow capsules or who require a low dose of fluoxetine, i.e. half a tablet.

Further information about fluoxetine changes is available here.

New regulations for prescribing medicinal cannabis products

Medicinal cannabis products are defined as any product containing substances extracted from cannabis for therapeutic use. Sativex is currently the only Medsafe approved medicinal cannabis product in New Zealand. New regulations have now come into effect, to improve the prescribing process; the aim is to streamline the approval of products, while ensuring a minimum quality standard, via the recently established Medicinal Cannabis Agency. As of 1 April, 2020, any practitioner can now prescribe Sativex and any other medicinal cannabis product that meets the quality standards*, for any indication (within their scope of practice and where there is a clinical need).

* No applications for product assessments have currently been received by the Medicinal Cannabis Agency

For more information on the new regulations and prescribing, visit the Ministry of Health or Medsafe websites.

Paper of the week: Should probiotics be recommended to patients with gastrointestinal conditions?

Over the last twenty years there has been a boom in the production, marketing and use of probiotics based on their reported health benefits. However, there has been little objective guidance for clinicians about appropriate use of these products. The American Gastroenterological Association (AGA) has just released a clinical practice guideline examining the role of probiotics in patients with gastrointestinal conditions.

The main findings were:

  • There are significant knowledge gaps in the current evidence
  • For the majority of gastrointestinal conditions, probiotics have not been found to be either safe or effective

Su G, Ko C, Bercik P, et al. AGA Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology 2020; [EPub ahead of print]. doi:

This Bulletin is supported by the South Link Education Trust

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