Category Archives: Medication

High-dose B12 therapy

The standard maintenance course of injectable B12 (after the two week loading period) is 1 mg every three months. Occasionally, I’ve come across a patient who finds that the effects of the injection wear off, and the symptoms of deficiency … Continue reading

Posted in Credits 2018, Haematology, Medication | Leave a comment

Apixaban interactions

Letter through from the pharmacy company regarding apixaban; apparently it interacts with SSRIs/SNRIs, which potentiate its action. So use with caution. Clarithromycin does not potentiate its action, although the letter didn’t specify whether QT prolongation would be a potential issue.

Posted in Anticoagulants, Credits 2018, Medication | Leave a comment

Second-line drugs in diabetes

I love studies that explore the practical questions we wrestle with in day-to-day work. So, I was pleased to see the BMJ study ‘Sulfonylureas for type 2 diabetes‘ (Douros et al). The presentation of the results in the written journal … Continue reading

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Don’t use bath additives for children’s eczema

A simple and extremely useful study result; in children with eczema, don’t bother prescribing those additives that you put in the bath water. The BATHE study studied children from 1 to 11 with eczema (‘very mild’ eczema was excluded) who … Continue reading

Posted in Credits 2018, Dermatology, Medication | Leave a comment

Slow initiation of warfarin protocol.

We’re all familiar with the usual 5mg warfarin initiation protocol (and many of us have distant memories of the 10-10-5 regimes started in hospital, or at least that’s what was being done when I was a junior doctor, back in … Continue reading

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Ulipristal warning

There’s a new warning out about ulipristal acetate 5 mg tabs (Esmya); it has been found to cause serious liver injury in some cases. The advice from the MHRA is that no new courses should be started, even in patients … Continue reading

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Migraine in pregnancy

The good news is that pre-existing migraine often gets better in pregnancy, especially migraine without aura and premenstrual migraine. However, it’s important to know a) how to treat it when it occurs and b) how to avoid confusing more dangerous … Continue reading

Posted in Credits 2018, Medication in pregnancy, Migraine, Pregnancy and Childbirth | Leave a comment