Prescribing and Medicines Management
Somerset medicines management website aims to provide prescribers with the most up to date policies, documents and guides to better prescribing.
The Medicines Management Team ensure that local formularies, medicines optimisation work, and commissioning decisions around prescribing reflect the needs of the Somerset population and allow the uptake of safe, cost effective, evidence based, innovative medicines and treatments.
With this in mind, consider also that:
- up to 50% of patients do not take their medicines as intended
- between five and eight per-cent of all unplanned hospital admissions are due to medication issues
- in primary care it is estimated at least £300m is spent each year on medicines that go to waste
- according to medication safety data, the NHS could do much better at reporting and preventing avoidable harm from medicines
- resistance to antibiotics presents a very real and significant threat to modern healthcare.
The Somerset Prescribing Formulary is a living document. It is continuously updated as prescribing decisions are made locally or as new national guidance is considered by the Somerset Prescribing Forum or local Drug & Therapeutics Committees:
Current News
For Scarlet Fever and GAS Guidance, see the NHS Somerset Infection Management Formulary Page.
Emergency Steroid Card
PrescQIPP has created some guidelines for the new NHS Steroid Emergency Card. For EMIS Web searches and protocols please contact your sessional pharmacist or locality manager.
Implementing the steroid card safety advice
Patients guide to NHS Steroid Emergency Card
Steroid Emergency Card guidance on using the searches
Neonatal & Paediatric Pharmacists Group Position Statement- Use of Steroid Medication Warning Cards for Children and Young People
Valproate Safety
Update on MHRA review into safe use of valproate – Update on MHRA review into safe use of valproate 12/12/22:
The CHM has advised that no one under the age of 55 should be initiated on valproate unless two specialists independently consider and document that there is no other effective or tolerated treatment. Where possible, existing patients should be switched to another treatment unless two specialists independently consider and document that there is no other effective or tolerated treatment or the risks do not apply.
Valproate use by women and girls MHRA updated guidance 11/02/2021 – Information about the risks of taking valproate medicines during pregnancy.
2022/23 Community Pharmacy Contractual Framework National Clinical Audit – Reducing the potential for harm from valproate prescribing in patients of childbearing age who are biologically able to be pregnant.
Specialist Pharmacy Service- SPS – Epilepsy: treatment during pregnancy
NHS Somerset formulary Contraception page
NHS Somerset formulary Mental Health page
Refer to the Somerset Traffic Lights System Document located on this page for details on individual drugs
Chapter 4.2 Epilepsy and other seizure disorders formulary page
NHS Somerset Medicines in pregnancy, children and lactation formulary page. The Safer Use of Medicines in Pregnancy Poster- Planning Ahead is now available, posters will be sent out to providers in early 2023.
Drug Interactions
Drug interactions go far and wide, the BNF include a complete section on grapefruit juice which totals 97 interactions.
Do other fruit juices affect the drug absorption of the medication you’re prescribing? Apple, orange and grapefruit may also affect absorption by inhibiting OATP transporters in the digestive system, a 4 hour delay between taking affected medication and those fruit juices is advisable.
Related Documents
- Somerset-Traffic-Light-System-52nd-Edition-Feb-2023.pdf
- NHS-Somerset-Specials-Guidance-Version-9.1-March-2022-with-updates-to-August-2022.pdf
- Managing-common-infections-Guidance-for-Primary-Care-Dec-22-v1.0.pdf
- Managing-common-infections-Quick-Reference-Guide-Dec-22.pdf
- Formulary-Quick-Reference-Guide-and-Preferred-Brands-September-2022.pdf
- Continence-Preferred-Product-List-for-Adults-Quick-Reference-Guide-July-2022.pdf
- Emollient-Guidance-v2-January-2022-2.pdf
- Wound-formulary-V17-December-2019-1-2.pdf
- Medicines-Clinical-Tasks-Guidance-2019_20-1.pdf
- 5.3.Lixiana-Practical-Guide-2021-1.pdf
- 5.5.Just-In-Case-Protocol-CCG-version-2.3-Feb-2017-Final-1.pdf
- UKMIQA-CBD-oil-AE-1.docx
- Adrenaline-auto-injector-advice-on-use-for-GPs-and-patients-October-22.pdf
- Sip-feed-comparison-chart-February-2023.pdf