Update to Red Amber List – March 2021

Following a recent meeting of the Regional Group on Specialist Medicines, there have been a number of changes/additions to the Red Amber List and a number of shared care guidelines and GP information sheets have been endorsed for use. These changes are summarised in the letter available at the link below:

Update to the Red Amber list (March 2021)

To keep up to date with these changes, please add your email address to our mailing list on our homepage

Revised monitoring schedules for some Adult DMARD shared care guidelines

Following a period of engagement with relevant specialists regarding the NI Regional DMARD shared care guidelines in the light of COVID, some of these guidelines have been reviewed to include a relaxed monitoring schedule for specific adult patients. These have now been endorsed by the Regional Group on Specialist Medicines (see update letter).

These reviewed guidelines have been uploaded to our website and are available at the links below:

Methotrexate adult (oral)
Methotrexate adult (subcutaneous)
Leflunomide
Ciclosporin
Penicillamine

You may wish to familiarise yourself with these revised monitoring schedules noting specifically that:

  • The usual monitoring arrangements remain unchanged
  • Any recommendation to move to a relaxed schedule must be advised by the specialist to the GP on a patient specific basis
  • A summary of the monitoring changes can be found here

If you have any queries about this communication please contact your local interface pharmacist for specialist medicines

Are Medications for treatment of Erectile Dysfunction on the Red list (or not)?

GP practices and Specialists frequently ask for clarification on the status of medicines for erectile dysfunction.

The entry on the Red Amber list reads as ‘Red – Severe distress caused by impotence’.

Two Department of Health Circulars provide guidance on circumstances when GPs can prescribe under ‘S11’ regulations, and when they should not. (HSS(PCCD) 18/99 and HSS(SC) 2/99).

In circumstances where GPs can prescribe, the medicines are not classified at all (neither Red nor Amber). Examples from the Circular of such causes of impotence include: diabetes, multiple sclerosis, Parkinson’s disease, poliomyelitis, prostate cancer, prostatectomy, radical pelvic surgery, renal failure treated with dialysis or transplant, single gene neurological disease, spinal cord injury, spina bifida.

The Circulars use the term ‘Severe distress’ as a category to describe those circumstances where the GP should not prescribe. In those circumstances, the medicines are considered Red list.

When you are reviewing a request to supply, it may be useful to refer to the list of conditions described above, and if the patient does not have any of the conditions listed, then further investigate whether supply should be made via secondary care.

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