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Published: 11 December, 2020


Are you up to date with what’s new in the NZF?

A new monograph for empagliflozin, a sodium-glucose co-transporter 2 (SGLT-2) inhibitor for patients with diabetes has now been included in the NZF. Empagliflozin is currently being considered for funding by PHARMAC with a decision expected in early February.

For further information on the PHARMAC proposal, see

Guidance on the management of stroke is now updated, including the place and timing of short term dual anti-platelet therapy, e.g. aspirin and clopidogrel, and changes to advice on secondary prevention, e.g. high potency statins recommended irrespective of the patients’ lipid levels.

There are changes in a number of other guidance sections in the December NZF release. Did you know you can sign up to receive monthly emails about significant changes in the NZF? This is a good way to keep up to date with what is new.

HIV PrEP harms event reported

The Centre for Adverse Reactions Monitoring (CARM) has been informed of a harms event occurring during the prescription and dispensing process of HIV pre-exposure prophylaxis (PrEP) in a primary care setting. This resulted in the prescription of tenofovir disoproxil monotherapy rather than the combination product emtricitabine with tenofovir disoproxil. This has highlighted the importance of prescribing by active ingredients (in this case: emtricitabine/tenofovir disoproxil) rather than by supplier/sponsor (“Teva”). In addition to prescribing by generic name, CARM suggest that the indications for prescription should be confirmed with the prescriber or patient at the time of dispensing as this should reduce the likelihood of a preventable harms event.

Unlike the combination emtricitabine/tenofovir PrEP product, tenofovir disoproxil monotherapy can be dispensed without Special Authority approval. However, it is only indicated as monotherapy in patients with chronic hepatitis B. For HIV treatment and prevention strategies, it is always used in combination with other antiretroviral medicines.

For further information on PrEP, see

National contraception guidance out now

The Ministry of Health’s guidance on contraception has been published and is available here. This document covers a range of issues specifically intended for a New Zealand audience and includes information on providing effective contraception counselling, contraception following pregnancy and the range of contraception options available. bpacnz will be updating our contraception article series to reflect the new guidance.

Paracetamol supply issues ongoing

PHARMAC advise that there are ongoing issues with the supply of paracetamol tablets and that supply is affected at a global level. There are multiple reasons for this with issues at various stages of manufacture and supply, and damage to a recent shipment resulting in rejection of product. Further supplies are expected in mid-December which will ease demand, but it is not expected that the problems will be fully resolved for several months.

Paper of the week: New WHO guidelines on Physical Activity

The World Health Organization (WHO) have released their new Guidelines on Physical Activity and Sedentary Behaviour. This document updates their 2010 guideline and provides recommendations largely at a public health level, but also with direct relevance to primary care. The evidence-based recommendations reflect the changes in research on physical activity which have occurred over the intervening years since the previous guideline.

This Bulletin is supported by the South Link Education Trust

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