The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Linzagolix (Yselty®) has been accepted for use in adult women of reproductive age for symptomatic treatment of endometriosis in women with a history of previous medical or surgical treatment for their endometriosis. This recommendation is consistent with published NICE guidance.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
The Department of Health and Social Care has recently announced a change to the prescribing restrictions for antiviral medicines for influenza. The requirement that an notification be issued by the Chief Medical Officer has been removed.
Prescribing of antivirals is now possible year-round in response to outbreaks for the treatment of influenza-like illness and post-exposure prophylaxis year round provided the the other restrictions are still satisfied. An SLS endorsement on the prescription is still required as defined in the Drug Tariff.
There should be clinical suspicion that influenza is circulating locally, and the patient:
- must have influenza-like symptoms currently
- OR have been in direct contact with someone who has these symptoms in the case of prophylaxis
- AND be in a clinical risk group (see below) if under 65
- OR is over 65 years old
- AND be able to start the anti-viral medicine within 48 hours of the onset of symptoms
The defined clinical risk groups are:
- chronic respiratory disease
- asthma that requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission
- chronic heart disease
- chronic renal failure
- chronic liver disease
- chronic neurological disease
- diabetes
- immunosuppression
Full prescribing information for treatment and prophylactic doses is available at CKS for oseltamivir and zanamivir.
Action: Clinicians should be aware of this change and that there is no longer a need to await annual notification of activation before prescribing these medicines.
During September 2025 Clinical Knowledge Summaries were published or updated in the following areas.
All of the topics have been reviewed and updated with minor structural and layout changes. The Addison's disease topic has been updated with recommendations from the NICE guideline Adrenal insufficiency: identification and management have been incorporated into this topic. The Tiredness/fatigue in adults topic has been updated in line with current evidence in the literature. Recommendations on the diagnosis and management of suspected or confirmed myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) now link to a new CKS topic on Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of September 2025. This month there are two technology appraisals, five guidelines and two health technology evaluations that impact upon primary care.
The Tirzepatide for treating type 2 diabetes technology appraisal and the Tirzepatide for managing overweight and obesity technology appraisal have both been updated to include reference to a commercial access agreement and pricing information for tirzepatide after a recent price rise.
The Bipolar disorder: assessment and management clinical guideline has been updated. It covers recognising, assessing and treating bipolar disorder (formerly known as manic depression) in children, young people and adults. The update amended recommendations on using valproate in line with MHRA safety advice that boys and men should be advised to use effective contraception (condoms, plus contraception used by a female sexual partner) throughout the valproate treatment period and for 3 months after stopping valproate.
The Pneumonia: diagnosis and management guideline has been published. It covers diagnosing, assessing and treating community-acquired and hospital-acquired pneumonia, including bacterial pneumonia secondary to COVID-19, in babies over 1 month (corrected gestational age), children, young people and adults. It aims to optimise antibiotic use and reduce antibiotic resistance.
The Suspected acute respiratory infection in over 16s: assessment at first presentation and initial management guideline has been updated. It covers assessment of people aged 16 and over with symptoms and signs of acute respiratory infection (bacterial or viral) at first remote or in-person contact with NHS services. The update has removed the section on clinical diagnosis of community-acquired pneumonia in primary care. This information is covered by NICE's guideline on Pneumonia: diagnosis and management.
The Chronic heart failure in adults: diagnosis and management guideline has been updated. It covers diagnosing and managing chronic heart failure in people aged 18 and over. The update amended the recommendations on heart failure with reduced ejection and added new recommendations on heart failure with mildly reduced and preserved ejection fraction.
The Digital technologies to support self-management of COPD: early value assessment technology evaluation and the Digital technologies to deliver pulmonary rehabilitation programmes for adults with COPD: early value assessment technology evaluation have both been updated. Active+me REMOTE has been removed from both evaluations. This technology is no longer available to the NHS because the technology company has ceased trading.
The Atopic eczema in under 12s: diagnosis and management guideline has been updated. It covers diagnosing and managing atopic eczema in children under 12. The update amended the section on complementary therapies, washing and clothing and added a link to an education resource to the section on education and adherence to therapy.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency (MHRA) has published a Drug Safety Update article for September 2025.
This update reminds and reassures patients and clinicians that there is no evidence that taking paracetamol during pregnancy causes autism in children. Paracetamol is recommended as the first-choice pain reliever for pregnant women, used at the lowest dose and for the shortest duration. It also acts as an antipyretic and is therefore used to treat fever.
This update has been issued after a recent US announcement suggested a link. It is noted that there is no robust evidence to support this claim. Patients are advised that they should not stop taking their pain medicines as untreated pain and fever can pose risks to the unborn child.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
