Medicines update

Neuro risk prompts metoclopramide PI change

Product Information for the antiemetic and gastroprokinetic drug metoclopramide has been updated to include a new contraindication to reduce the risk of neurological adverse events.

There are also changes to the drug’s dosing and duration of use, as revealed by the TGA in its latest Medicines Safety Update.

The TGA said it has received 2190 adverse event case reports associated with metoclopramide over a 43 year period. Among these were 16 cases of tardive dyskinesia and 86 cases of other extrapyramidal disorders.

There were also nine reports of cardiac arrest and a further 63 reports of cardiac arrhythmias.

PI changes include a maximum dosage for adults of 30 mg daily, with a maximum treatment duration of five days in all age groups. It is only to be used as a second-line therapy in young adults and children.

Adhere to Vit D guidelines: expert

Vitamin D supplementation should only be started in patients with low circulating levels of vitamin D are low and when patients are at increased risk of falls or fractures, an experts advises.   

In the latest edition of Australian Prescriber, University of WA endocrinologist, Dr Paul Glendinning states that vitamin D testing is very commonly requested, but new Australian guidelines state for whom supplementation should be used. 

“Vitamin D testing has become more common, but testing is recommended for those at risk of vitamin D deficiency, not for healthy babies, children and adults,” he said.