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News and updates from palliativedrugs.com
  1. Andrew Wilcock1 and
  2. Sarah Charlesworth2
  1. 1Palliative Medicine, University of Nottingham, Nottingham, UK
  2. 2Hayward House Study Centre, palliativedrugs.com, Nottingham, UK
  1. Correspondence to Dr Andrew Wilcock, Department of Palliative Medicine, University of Nottingham, Hayward House Study Centre, Nottingham University Hospitals NHS Trust, NG5 1PB, UK; andrew.wilcock{at}nottingham.ac.uk

https://doi.org/10.1136/bmjspcare-2013-000644

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    Safety updates

    MHRA strengthened recommendations for intravenous iron

    The UK Medicines and Healthcare products Regulatory Agency (MHRA) has strengthened recommendations for the administration of intravenous iron in relation to serious hypersensitivity reactions. An Europe-wide review has shown that these can occur irrespective of whether a patient has received a test dose or previous treatment with the product. Thus, because of the false reassurance they can confer, a test dose is no longer recommended. Intravenous iron should be administered strictly as per the specific Summary of Product Characteristics (SPC) (advice varies between products). With every dose of intravenous iron, resuscitation facilities must be available and patients monitored for signs of hypersensitivity during the infusion and for 30 min afterwards.

    MHRA strengthened contraindications for apixaban and rivaroxaban

    The UK MHRA has strengthened contraindications for the new oral anticoagulants apixaban (Eliquis) and rivaroxaban (Xarelto) in line with those for dabigatran (Pradaxa) that were introduced in July 2012. All three new oral anticoagulants are now contraindicated in patients with a lesion or condition that is considered a significant risk factor for major bleeding. Examples include; current …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.