Seven minute briefings

The GMMMG Medicines Safety Subgroup has produced a new series of 7 minute briefings. These pieces are intended to facilitate shared learning regarding medicines, particularly where there are cross-sector implications.

The first topics have now been approved by CEGC, and are available on a dedicated page of the GMMMG site. They are:

  • Cyclizine dependency
  • Nitrofurantoin: pulmonary and hepatic adverse drug reactions
  • Tramadol and warfarin interaction

All of these topics, and any future ones, are available on the 7 minute briefings page of the site.


Decisions approved by GM ICB Executive – April 2024

The decisions made at the Greater Manchester Medicines Management Group (GMMMG) April 2024 meeting have now been reviewed by GM Executive and can be found at https://gmmmg.nhs.uk/meetings/decision-summaries/. This includes the recommendations made by GMMMG in April 2024 and NICE Technology appraisals published in December 2023.

The following decisions were approved and can be found at:

Colleagues are asked disseminate for implementation within your organisations.

All approved CRG and GMMMG meeting minutes can be found at: https://gmmmg.nhs.uk/meetings/clinical-reference-group/ and https://gmmmg.nhs.uk/meetings/gmmmg-meetings/.


New consultation: CRG actions May 2024

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the May 2024 CRG meeting. Actions in this consultation include:

  • Levomepromazine 6.25mg tablets – green, alternative option where small doses are required and tablet splitting is not appropriate
  • Phenobarbital 15mg/5ml elixir – green (specialist advice) and grey (criterion 1), only for select adult patients for whom ethanol consumption is safe and appropriate. Not for use in children.
  • Bowl cleansing preparations – red, and product list updated to Plenvu, sodium picosulfate with magnesium citrate, and Klean-Prep
  • FreeStyle Libre 2 plus and Dexcom One plus – add as additional options for new and existing patients

All links to NICE clinical guidelines and MHRA drug safety updates will be added to formulary as appropriate.

This consultation will run for six weeks and closes at 5pm on Friday 5th July 2024. To take part, visit the consultations page.


New consultation: communication standards for opioid medicines prescribed at discharge

On behalf of the GMMMG Medicines Safety Group, we now seek comments on draft Communication Standards for Opioid Medicines Prescribed at Discharge.

The draft document has been developed to support safe prescribing of opioids by improving and standardising the information communicated from secondary care to primary care when patients are discharged from hospital with an opioid medicine for pain management. The document has been developed by a task and finish group on behalf of the GM Medicines Safety Group. The document has been reviewed by members of the task and finish group, Medicines Safety Group, and has been circulated via the chief pharmacists group for comments.

This consultation will run for six weeks and closes at 5pm on Thursday 27th June 2024. To take part, visit the consultations page.


New consultation: CRG actions April 2024

On behalf of the GMMMG Clinical Reference Group, we now seek comments on the actions proposed at the April 2024 CRG meeting. Actions in this consultation include:

  • Lamotrigine tablets – green specialist advice for bipolar disorder
  • Doxylamine / pyridoxine for nausea and vomiting in pregnancy – removed from grey list and made a first choice option alongside cyclizine and prochlorperazine
  • Levemir InnoLet and Insulatard InnoLet – remove from formulary following discontinuation of the products
  • Buprenorphine prolonged release solution for injection (Buvidal) – add to formulary as alternative to methadone and oral buprenorphine
  • Fluocinolone intravitreal implant – RED
  • Dupilumab for prurigo nodularis – DNP
  • Etrasimod for ulcerative colitis – RED
  • Ritlecitinib for alopecia areata – RED
  • Satralizumab for neuromyelitis optica spectrum disorders – DNP
  • Sebelipase alfa for lysosomal acid lipase deficiency – DNP

All links to NICE clinical guidelines and MHRA drug safety updates will be added to formulary as appropriate.

This consultation will run for six weeks and closes at 5pm on Friday 24th May 2024. To take part, visit the consultations page.


Decisions approved by GM ICB Executive – March 2024

The decisions made at the Greater Manchester Medicines Management Group (GMMMG) March 2024 meeting have now been reviewed by GM Executive and can be found at https://gmmmg.nhs.uk/meetings/decision-summaries/. This includes the recommendations made by GMMMG in March 2024 and NICE Technology appraisals published in November 2023.

The following decisions were approved and can be found at:

Colleagues are asked disseminate for implementation within your organisations.

Drugs with a NICE recommendation published in December 2023 have been considered by CRG at its March 2024 meeting, and will be considered for approval by GMMMG and CEGC at their April 2024 meetings.

All approved CRG and GMMMG meeting minutes can be found at: https://gmmmg.nhs.uk/meetings/clinical-reference-group/ and https://gmmmg.nhs.uk/meetings/gmmmg-meetings/.


New consultation: salbutamol inhaler switch

On behalf of the NHS Greater Manchester Green Plan Oversight Group, we now seek comments on a proposal for an active switch from Ventolin Metered-Dose Inhaler (MDI) or generic salbutamol MDI to Salamol MDI in primary care.

This consultation will run for six weeks and is open until 5pm on Thursday 16th May 2024. To take part, visit the consultations page.


GMMMG updates – March 2024

Following the March meetings of GMMMG and CEGC, the following actions have been published to the GMMMG website.

Updates to guidelines include:

  • Gabapentinoid resource pack re-published
  • Pathway guidance for managing GLP-1 agonist shortages in adults updated
  • Advice on use on tirzepatide published

Formulary and RAG updates include:

  • Foslevodopa with foscarbidopa added as red

Links to NICE guidance and MHRA safety advice added as appropriate. For full details of formulary and RAG updates, see the formulary change log available on the formulary page.

The following decisions await approval by the GM ICB Executive:

  • Cytisine 1.5mg tablets for smoking cessation – Green first line option
  • Empagliflozin for treating chronic heart failure
  • Riluzole shared care protocol (update)
  • Slenyto rebate scheme

GMMMG updates – January & February 2024

Following the February meetings of GMMMG and CEGC, the following actions have been reviewed by the GM ICB Executive and published to the GMMMG website.

Formulary and RAG updates include:

  • Mirikizumab for ulcerative colitis added as RED
  • Acetylcysteine 600mg effervescent tablets added as GREEN, first choice and carbocisteine tablets made GREEN alternative for use as mucolytics in COPD
  • Tirzepatide for type 2 diabetes added as GREEN, as an alternative to GLP-1 mimetics
  • Carbimazole 10mg & 15mg tablets added to DNP list
  • Gepretix 100mg micronised progesterone added as an additional option for women requiring progesterone for HRT
  • Tofacitinib for active ankylosing spondylitis added as RED
  • Bimekizumab for active psoriatic arthritis and axial spondyloarthritis added as RED

Links to NICE guidance and MHRA safety advice added as appropriate. For full details of formulary and RAG updates, see the formulary change log available on the formulary page.

More details of the published decisions are available from the decision summaries page.


New consultation: statins for primary CV prevention in HIV

Following discussion at the February 2024 meeting of CRG, we now seek comments on a draft position statement on prescribing statins for primary prevention in HIV.

This consultation will run for six weeks and closes at 5pm on Friday 12th April 2024. To take part, visit the consultations page.