SPS - Paxlovid Interactions - Do Not Use codelist

[rose-higgins]

Do not use codelist - notes Related to #158 and #170 <- Paxlovid Caution codelist issue

Notes on the inclusion/exclusion in this codelist are present here and copied below next to the drug entry in the list. Codelist saved as a draft here.

Fusidic acid (oral) - infections and eye chapter drugs included, skin chapter excluded

Salmeterol (inhaled) - included all (no restriction to formulation as not clear from some entries). Included Fluticasone/Salmeterol combos

Sodium fusidate (oral) - included infections chapter, excluded skin chapters (as topical/or ointments)

St. John’s Wort (Hypericum perforatum) - Results in DM+D mostly refer to homeopathic hypericum perforatum? BNF codes for 2 formulations are available: 'Calendula officinalis 0.45% / Hypericum perforatum 0.45% cream 30 gram' and 'Calendula officinalis 500ml/litre / Hypericum perforatum 500ml/litre spray 30 ml' which aren't homeopathic, but haven't been included for now

Drugs with no BNF code (not currently included in the codelist) Dihydroergotamine Neratinib Venetoclax

[brianmackenna]

As a quick note on Do not use codelist could we try wort or john as the search criteria. I think with current entry St. John’s Wort it might have missed some entries. (separately I need to think a bit more about this product as it is treated differently for BNF coding than dm+d)

[rose-higgins]

I have added the entries under 'wort' and 'john' which refer to St John's Wort.

[rose-higgins]

The website containing the document which the codelist was developed from is here. The document itself was first published on 28th Jan 2022 (this version here), and this document was updated on 2nd Feb 2022 (here). The updated version is the one the codelist on OpenCodelists has been developed from.

The update included the addition of 10 drugs, listed below: Cladribine Methylprednisolone Modafinil Primidone Quinine Rifaximin Riluzole Siponimod Tetrabenazine Trihexyphenidyl

[richiecroker]

Just taking a look at this, a few comments in relation to the sheet:

Contraception

I think we should use 7.3.11 (Combined hormonal contraceptives and systems), 7.3.2 (Progestogen-only contraceptives) and 7.4 (Emergency contraception) as codes. @brianmackenna ?

Dexamfetamine

Dexamfetamine is new correct spelling of dexamphetamine. Interesting question re lisdexamfetamine, as it's an inactive prodrug and converted to dexamfet in the body. Should we ask SPS for their opinion @brianmackenna

Illegal drugs

I don't think this would be searchable

The draft codelist seems reasonable, although you could probably remove the cholesterol cream.

[richiecroker]

One other small comment - i wonder if we could get a better name for the codelist. I keep looking at it thinking it means we shouldn't use the codelist. It would be good to come up with standard nomenclature for cautions and CIs

[brianmackenna]

Contraception: this is a caution so not appropriate for this codelist. Unless I'm missing something? Lisdexamfetamine: yes to asking SPS but I would finalise list now.

[richiecroker]

@brianmackenna with or without lisdex?

[brianmackenna]

without as not in SPS list that I can see.

[richiecroker]

OK that seems reasonable - the SPC doesn't mention it

[rose-higgins]

Just to clarify - the only action you have suggested for the 'Do not use' codelist is to remove the Cholesterol/simvastatin that exists in the Skin chapter (referring to your comment below @richiecroker)? can you confirm it is the one i have put red brackets around (if not which one were you referring to?)

although you could probably remove the cholesterol cream.

[richiecroker]

@rose-higgins yes the bracketed skin product can be removed.