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Cannabis-based products (part 2): cannabis plant & tetrahydrocannabinol (THC) - October 14, 2019
Legal changes in December 2018 allow the use of the cannabis plant (Cannabis sativa) for palliative care, and prescribed tetrahydrocannabinol (THC) will be more accessible later this year. This bulletin aims to clarify the legal status and evidence for the cannabis plant and its main active const...



Antidepressants and Breastfeeding - October 4, 2019
Infant exposure to antidepressants via breast milk is generally low. Post-natal depression affects 10-15% of women and is often treated with antidepressants. The benefits of breastfeeding, and treating depression, usually outweigh any theoretical risk to the infant posed by antidepressants. It is...



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....



‘Sulfur allergy’ - July 17, 2019
The term ‘sulfur allergy’ is misleading. It can lead to patients believing that they are allergic to all sulfur-containing medications or preservatives, and even to sulfur, an important building block of life. It can also cause potentially useful medicines to be unnecessarily avoided. The ter...



Treatment of Allergic Rhinitis in Pregnancy and Breastfeeding - May 30, 2019
Allergic rhinitis is characterised by symptoms such as sneezing, a runny, itchy or blocked nose and itchy, watery eyes. It is very common, affecting up to 30% of the adult population. People with seasonal rhinitis ("hay fever") exhibit symptoms at specific times of the year (usually spring and su...



Vildagliptin for diabetes – funded in NZ - March 29, 2019
There are over 240,000 people in NZ currently diagnosed with diabetes mellitus (mostly type 2), and possibly another 100,000 undiagnosed. In October 2018, vildagliptin became the first dipeptidyl peptidase-4 (DPP-4) inhibitor funded in NZ. It is one of a number of DPP-4 inhibitors used internatio...



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...



Sacubitril + valsartan for heart failure - November 5, 2018
Sacubitril + valsartan is now available in New Zealand and fully subsidised under Special Authority criteria. Eligible patients must have NYHA/WHO functional class II, III or IV heart failure; a left ventricular ejection fraction of <35%; and be receiving standard heart failure therapy. It can...



St John’s wort (Hypericum perforatum) - November 1, 2018
November 2018
There is far less information about the effectiveness, safety and potential for interactions for complementary and alternative medicines (CAMs) compared to conventional medicines. There is no regulation of their quality or contents in New Zealand.
Consider also othe...



Repackaging dabigatran into compliance packs - October 8, 2018
Compliance packs
With an ageing population there is increasing incidence of multimorbidity and polypharmacy. This leads to complex dosing regimens.
Compliance aids, such as the Medico Paks® or unit dose medication sachets, are widely used to manage complex medication regimes, and help remind...