Bulletins
Filter by category:
AdministrationAdverse drug reactionsCannabis-based productsComplementary and Alternative Medicines (CAMs)COVID-19Drug comparisonsInteractionsNew medicineOtherPharmacokineticPregnancy/BreastfeedingAbsorption of medicines following bariatric surgery - November 22, 2024
In Aotearoa New Zealand 1 in 3 adults (≥ 15 years) are obese (BMI ≥ 30 kg/m2).1 Around 2000 bariatric procedures are performed each year; approximately half are restrictive, and half are restrictive-malabsorptive.2 Restrictive procedures e.g. gastric sleeve (GS), reduce the size of the stomac...
Analgesia during pregnancy or while breastfeeding - November 19, 2024
Treatment of acute pain (e.g. headache, soft tissue injuries, or following minor procedures) in pregnant and breastfeeding women follows the same principles as for all adults (illustrated below).
Mild to moderate pain:
Paracetamol +/- NSAID e.g. ibuprofen or celecoxib
Moderate pain:...
Assessing medicines when stored outside manufacturer recommendations - August 7, 2024
Storage of medicines per manufacturers’ specifications ensures medicines are fit for purpose. If stored outside these specifications, or used beyond the expiry date, medicines may be less effective, and/or have increased toxicity. This bulletin provides a framework for considering whether medic...
Medicines and Meals – Food for Thought? - June 24, 2024
The timing of medicine administration in relation to food is not important for most medicines. In general, patients should be advised to take their medicines consistently at the same time with respect to meals.
Adherence to medicines is a primary determinant of treatment success.
Poor adh...
SGLT2 Inhibitors and GLP-1 Receptor Agonists - January 3, 2024
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) e.g. empagliflozin & glucagon-like peptide-1 receptor agonists (GLP1RA) e.g. dulaglutide & liraglutide are increasingly being used in NZ for type 2 diabetes and other conditions such as heart failure & obesity. Currently their funded...
Can transdermal patches be halved? - May 16, 2023
Sometimes it is necessary to give a lower patch dose than is available. This problem has become more frequent with supply issues for some patch doses. Manipulation of a dose form can affect pharmacokinetics and stability, although there are very few studies involving patches. Cutting or occluding...
Antidepressant Use in Pregnancy - March 31, 2023
Depression affects approximately 10% of pregnant people and is associated with adverse parental and foetal outcomes, including compromised parenting, which can impact on child development.(1) Some data suggest that antidepressants may increase the risk of spontaneous abortion, preterm delivery an...
Treatment of Nausea and Vomiting in Pregnancy - January 23, 2023
Nausea, with or without vomiting, is common in pregnancy, affecting up to 80% of women. Symptoms usually begin between four and seven weeks, peak at nine weeks, and resolve by 16 to 20 weeks. Up to 2% of women develop hyperemesis gravidarum, where persistent vomiting may lead to dehydration, weig...
Crushing nirmatrelvir+ritonavir (Paxlovid®) tablets - December 22, 2022
Background
Pfizer state in their prescribing information that both nirmatrelvir and ritonavir tablets should be swallowed whole and not chewed, broken, or crushed. [1] This is due to a lack of pharmacokinetic data to support administration in this manner. However, a Phase 1 study with a nirmatre...
Pharmacokinetic medicines interactions with probenecid - November 29, 2022
Probenecid was introduced in the 1950’s to reduce the renal elimination and extend the plasma half-life of penicillins. This effect is exploited therapeutically in the treatment of cellulitis and other infections. It is also used for gout prophylaxis, in light of its uricosuric effects.
Prob...