Medicines Information & Drug Safety Updates

February 2019 – SGLT-2 inhibitors are medicines that lower blood sugar by increasing the amount of glucose excreted in the urine. SGLT-2 Inhibitors are used in diabetes and also have benefits in kidney disease heart failure.

They include:

• empagliflozin (Jardiance®)
• canagliflozin (lnvokana®)
• dapagliflozin (Forxiga®)
• ertugliflozin (Steglatro®).

If you take one of these medications you should be aware of the potential side effects as, if they are not identified early, they can serious problems. As with all medication please read any information that accompanies the medication carefully. Please ask your Pharmacist, diabetic nurse or GP if you have any questions. The major side effects include:

Diabetic ketoacidosis

Sympoms include: Nausea, vomiting, fast breathing, abdominal pains, unusual drowsiness, or fever.

Fournier’s gangrene

An extremely rare side effect affecting about 1.6 out of 100,000 people

Symptoms include: Severe pain, tenderness, redness, or swelling in the genital or groin area accompanied by fever or malaise.

If you have any of these symptoms, please contact a medical professional, such as a doctor or nurse immediately, even if your blood sugars are near normal.

If your GP practice is closed, please call the NHS 111 service, by dialling 111, for more advice. Tell them that you are worried about one of the conditions above.

Stop this medication until you have further medical advice.

Full updates can be found HERE

Some medicines are known or suspected to have the potential to increase the risk of birth defects and development disorders (teratogenic potential) when taken during pregnancy, especially during the first trimester (up to week 12 of pregnancy), when a woman may not know she is pregnant. The product information for these medicines advise that pregnancy should be avoided during treatment, with advice on the need to use contraception including, in some cases, formal pregnancy prevention programmes.

When using any medicine with teratogenic potential, a woman should be advised of the risks and encouraged to use the most effective contraceptive method taking into account her personal circumstances.

For more information on Teratogenic drug, visit:

Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed? – GOV.UK (www.gov.uk)

Teratogenic Drugs include:

Valproates, Carbimazole, Modafinil, Pregabalin, Topiramate

March 2022 – Amiodarone is used to treat certain types of abnormal heart rhythm, including atrial fibrillation and tachyarrhythmias (heart beats unevenly or too fast). Treatment should be initiated under hospital or specialist supervision and in accordance with clinical guidance.

Amiodarone is associated with serious adverse effects in several organ systems including the eyes, gastrointestinal tract, nerves, skin, thyroid, lungs, heart, and liver. Amiodarone has a long plasma half-life of around 50 days, meaning that any adverse effects may persist for a month (or more) after treatment has stopped. Patients must be monitored closely during treatment

Advice for patients and carers:

Always read the patient information leaflet provided with your medicines and follow the advice on other medicines to avoid and what to do if you have a side effect.

Your doctor may perform tests of your blood, lungs, heartbeat, and eyes before and during treatment – it’s important to have these tests because they can identify if there’s a problem. During treatment blood tests are advised every 6 months.

Stop taking amiodarone and see a doctor or go to a hospital straight away if you experience any of the following during treatment or in the period after stopping amiodarone:

• Any loss of eyesight

• New or worsening shortness of breath or coughing that will not go away 

• Yellowing of the skin or eyes (jaundice), feeling tired or sick, loss of appetite, stomach pain, or high temperature

• Weakness, weight loss or weight gain, heat or cold intolerance, hair thinning, sweating, changes in menstrual periods, swelling of the neck (goitre), nervousness, irritability, restlessness, or decreased concentration

• Your heartbeat becomes even more uneven or erratic, or becomes very slow

September 2020 – Recently issued National guidance promotes a patient-held Steroid Emergency Card to help healthcare staff identify patients with adrenal insufficiency and provide information on emergency treatment.

This means that there are now 2 types of steroid alert card a patient may be required to carry:

1. A steroid TREATMENT card (blue card)

This carries a series of instructions for the patient and informs healthcare professionals to whom the patient shows the card. The card should be carried when a patient is taking ORAL steroids. Patients taking oral corticosteroids for periods of more than three weeks should receive a steroid treatment card, or those receiving more than four short oral courses per year.

2. A steroid EMERGENCY card

Is a prompt to help healthcare staff to identify appropriate patients and gives information on the emergency treatment to start if they are acutely ill, or experience trauma, surgery or other major stressors.

The steroid emergency card should be given to all patients with primary adrenal insufficiency and those who are steroid dependent (on a long-term oral steroid).

Cards are available through community pharmacies or The card can be downloaded from the Society for Endocrinology adrenal crisis webpage. 

Further information is available HERE

November 2018 – Studies have shown a dose-dependent increased risk of non-melanoma skin cancer with exposure to increasing cumulative doses of Hydrochlorothiazide (contained in some combination products used for high blood pressure). Patients taking Hydrochlorothiazide should:

• Regularly check for and report any new or changed skin lesions or moles
• Limit their exposure to sunlight and UV rays and use adequate protection when exposed to sunlight and UV rays to minimise the risk of skin cancer
• Make an appointment to discuss alternative options to the use of hydrochlorothiazide if you would like to and particularly if you have had a previous skin cancer.

Further information at: https://www.gov.uk/drug-safety-update/hydrochlorothiazide-risk-of-non-melanoma-skin-cancer-particularly-in-long-term-use