Bulletins - Drug comparisons
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Levodopa – product shortages - April 24, 2020
There have been supply issues for medicines used to treat Parkinson’s Disease. Sinemet® (levodopa + carbidopa) brand has been discontinued in the USA. There have also been problems with supply of Madopar Rapid® (levodopa + benserazide) dispersible tablets. These supply problems mean that pati...



Oral Anticoagulants – Rivaroxaban and Dabigatran - October 1, 2019
Rivaroxaban (Factor Xa inhibitor), dabigatran etexilate (direct thrombin inhibitor), or warfarin (vitamin K epoxide reductase inhibitor) can be used as oral anticoagulants for most indications. Warfarin remains first line for patients with mechanical heart valves or severe chronic kidney disease....



Pregabalin - January 14, 2019
Pregabalin is now fully funded without restrictions both in hospitals (Hospital Medicines List) and in the community (PHARMAC Schedule). As the use of newly available medicines, particularly new medicines within a class, presents some challenges to clinicians the aim of the below is to familiaris...



Morphine and oxycodone – similarities and differences - February 1, 2016
Morphine is considered internationally to be the opioid analgesic of choice for the relief of moderate to severe pain. It is used in many areas of medicine including musculoskeletal injury, pre- and post-surgery and in malignant disease. Oxycodone is an opioid analgesic which has similar indicati...



Opioids and Laxatives - July 1, 2015
Clinical guidelines recommend that patients prescribed opioids should be co- prescribed laxatives. However, opioid induced constipation remains a common local and international problem associated with morbidity and mortality occurring in up to 90% of those taking opioids. Within CDHB hospitals fr...



Codeine and tramadol - May 1, 2015
The use of opioids has been of interest both nationally and locally. Codeine is the most commonly used opioid from step 2 of the WHO analgesic ladder within CDHB hospitals. The use of codeine and another step 2 analgesic, tramadol, are increasing in the CDHB.
Solid oral dose forms of codeine (...



Paracetamol – oral or intravenous (IV)? - August 1, 2014
Use of IV paracetamol has increased from 1,160 of the 1 g infusions (cost of $4,928) in the financial year 2006/2007 to 20,600 (cost of $81,852) in the financial year 2012/2013. A dose of 1 g of paracetamol costs $2.25 IV and $0.02 oral.
PHARMAC Hospital Medicines List (HML) restricts the use ...