MIMS May prescribing update

NEW PRODUCTS

Fluvax Junior is a new brand of inactivated influenza vaccine for the prevention of influenza caused by influenza virus types A and B in children aged six months to 35 months.

Contraindications include hypersensitivity to eggs and/or chicken feathers, neomycin, polymyxin B sulfate. Immunisation should not be performed during an acute feverish illness (fever >38.5ºC).

Usual dosage is 0.25 mL by either intramuscular (IM) or deep subcutaneous (SC) injection.

For infants younger than 12 months, the preferred site for IM injection is the vastus lateralis muscle in the anterolateral thigh, and for children 12 months or older, the deltoid muscle.

Refer to the Australian Immunisation Handbook for full recommendations.

Fluvax Junior is available on a private prescription as a single-use syringe.

• Zan-Extra 10/10 and Zan-Extra 10/20 are fixed-dose combinations of the calcium channel blocker, lercanidipine, and the ACE inhibitor, enalapril, for the treatment of hypertension (not for initiation of treatment).

Contraindications include hypersensitivity to any dihydropyridine calcium antagonist or ACE inhibitor, pregnancy, lactation, women of childbearing potential (unless effective contraception is used), severe renal impairment (creatinine clearance <30 mL/minute), severe hepatic impairment, co-administration with cyclosporin, history of angioedema.

SAFETY-RELATED CHANGES

Patients with serious psychiatric illness such as schizophrenia, bipolar disorder and major depressive disorder did not participate in the pre-marketing studies of varenicline tartrate (Champix) and its safety and efficacy in such patients has not been established.

Serious neuropsychiatric symptoms have occurred in patients being treated with varenicline. Some cases may have been complicated by the symptoms of nicotine withdrawal in patients who stopped smoking; however, some of these symptoms have occurred in patients who continued to smoke.

All patients being treated with varenicline should be observed for neuropsychiatric symptoms, including changes in behaviour, agitation, aggression, depressed mood, suicidal ideation and suicidal behaviour.

• For patients taking citalopram (Cipramil) who are known to be poor metabolisers with respect to CYP2C19, an initial dose of 10 mg daily during the first two weeks of treatment is recommended. The dose may be increased to 20 mg daily depending on individual patient response.

• Slow-release potassium chloride (Slow-K, Duro-K) should be used with caution in patients receiving any drug known to have a potential for hyperkalaemia such as ACE inhibitors, angiotensin-II-receptor-antagonists, NSAIDs (e.g. indomethacin), beta-blockers, heparin, digoxin and cyclosporin.

Concomitant treatment with potassium-sparing diuretics (aldosterone antagonists, triamterene, amiloride) is contraindicated. Anticholinergic drugs should be prescribed with great care when given concomitantly with solid oral potassium preparations, particularly in high dosage, as they may reduce gastrointestinal motility.

This list is a summary of only some of the changes that have occurred over the last month. Before prescribing always refer to the full Product Information.