This bulletin summarises the latest evidence on the safety of oral anticoagulants in breastfeeding. Dabigatran in Milk Study: We are also looking for participants in Canterbury who are taking dabigatran and breastfeeding who may be willing to be involved in research -more information is available in the bulletin.
Usual dose: 5 mg up to four times daily. Best taken about 30 minutes before meals to improve salivary flow for eating. To reduce the chance of adverse effects, treatment may be started more gradually, such as 5 mg once daily for the first week, then increased as tolerated. Common adverse effects include sweating, flushing,…
Free access is now available across primary and secondary care to the BNF, BNF for Children, Palliative Care Formulary, Psychotropic Drug Directory, Briggs Drugs in Pregnancy and Lactation, Stockley’s Herbal Medicines Interactions, and Stockley’s Drug Interactions. Primary care users need to register for a Health New Zealand OpenAthens account first: health-new-zealand.libguides.com/primarycare
Please review the latest Te Whata Kura (Aotearoa’s National Antibiotic Guideline) newsletter outlining recent updates and explaining decisions related to adult cystitis. Please also see the Te Whata Kura memo on use of antivirals for COVID-19 in adults.
We have made the following changes to our service: Our opening hours are now Monday to Friday 8:30am to 4pm (closed public holidays). Queries can still be submitted outside these hours via email, ERMS, our Query portal on this website, or answerphone. We are no longer able to answer queries from private hospitals and clinics. We…
There is limited guidance available for switching between GLP-1 RAs when used for weight loss. Much of the information comes from studies in people with diabetes and from authors’ opinions based on clinical experience. How to Switch Start with an equivalent dose of the new GLP-1 RA, or one dose lower. A conservative approach is…
This bulletin provides practical guidance for pharmacists preparing extemporaneous oral liquids, focusing on alternative pharmaceutical options, stability, common excipients, and useful resources.
Te Whata Kura, Aotearoa New Zealand’s national antibiotic guideline, officially launched on 18 December 2025 to provide consistent, equitable, and safe antibiotic advice across the country. Te Whata Kura replaces various hospital guidelines and is accessible as a web app for mobile and browser use.
Using a higher strength pen and “click counting” enables patients to save money on Wegovy® (semaglutide), i.e. to have additional doses from one pen. Hence this has become relatively common practice. This is ‘unapproved use’ of the product. We are not aware of problems being demonstrated from this practice. The manufacturer recommends against “click counting”…
See the recently published article in Australian Prescriber written by two of our local clinical pharmacologists on the use of oral anticoagulation for AF or VTE – link
The new national antibiotic guidelines, Te Whata Kura (going live Dec 2025), give updated recommendations on the use of antibiotics in patients with a previous allergic response to penicillin. Click on the following link to see the changes to the recommendations and the rationale here
This bulletin classifies the hazardous medicines available in Aotearoa, and provides information on safety measures to protect healthcare workers by minimising occupational exposure.
The national Compounding Working Group have recently published standard formulae worksheets for making valaciclovir, sotalol and famotidine suspensions. They can be found on the PSNZ site via this link
This bulletin helps to assess the risk of drug-induced QTc interval prolongation and includes links to useful resources.
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There is limited guidance available for switching between GLP-1 receptor agonists when used for weight loss. Much of the information comes from studies in patients with diabetes, or authors’ opinions based on clinical experience. Semaglutide generally leads to greater weight loss than liraglutide, but may also cause more gastrointestinal (GI) adverse effects (primarily nausea, vomiting…
This antimicrobial stewardship bulletin outlines the primary indications for applying topical antibiotics to the skin, and the harms that may result from their use.
Did you know two studies have recently been published (including one from Aotearoa!) exploring the stability of dabigatran etexilate in compliance aids? This bulletin is an update of our 2018 version, and summarises the key findings from these new studies.
Confused about cannabis? Consolidate your knowledge with our new bulletin on Cannabis-Based Products
Bariatric surgery has become increasingly common and has the potential to affect the absorption of medicines. This bulletin explains the types of procedures usually undertaken in Aotearoa and the effects these may have on physiological and pharmacokinetic changes.
This bulletin discusses treatment options for acute pain in people who are planning pregnancy, pregnant, or breastfeeding. While most guidance has not changed, we now suggest to consider avoiding non-steroidal anti-inflammatories (NSAIDs) around the time of conception. It also discusses the controversy with codeine use while breastfeeding.
The timing of medicine administration in relation to food is not important for most medicines, and patients should generally be advised to take their medicines consistently at the same time with respect to meals. This bulletin explores some of the myths around food and medicines, and highlights examples where an interaction with food may be…
There is a global shortage of estradiol patches, which is expected to continue for quite some time. Pharmac have more information here: pharmac.govt.nz/medicine-funding-and-supply/medicine-notices/oestradiol Pharmac funds a maximum of 8 patches of each strength per month. Patients must pay for any patches dispensed over this limit. All brands of estradiol patches (Lyllana®, Estradot®, Climara®, Sandoz®, Mylan/Viatris®…
SGLT2 inhibitors and GLP1 receptor agonists are being used increasingly in NZ for type 2 diabetes and other conditions such as heart failure and obesity. This bulletin gives an overview of these two classes of medicines.
It can be challenging to find reliable information on medicines. Check out our Useful Links page for a list of freely-available online medicines information resources.
Naltrexone 1 mg/mL (100 mL) Ingredients Naltrexone 100 mg (2 x 50 mg tablets) Ascorbic acid 500 mg (powder or crushed tablets) Preservative 0.1% (e.g. 1 mL compound hydroxybenzoate solution or 1 mL methyl hydroxybenzoate 10% solution: formula on Pharmac website) Glycerol 20 mL Water to 100 mL Method Crush naltrexone tablets and triturate with…
Sometimes it is necessary to give a lower patch dose than is available. This bulletin discusses preferred methods for halving patch doses, and the risks and benefits of this practice.
Triazolam will no longer be available in New Zealand once current stocks are exhausted from September 2023. See the notification from PHARMAC here. Triazolam is a very short-acting benzodiazepine, with a half-life of about 3 hours. For patients currently taking triazolam: Consider whether a benzodiazepine is still clinically indicated: Benzodiazepines are associated with considerable adverse effects,…
Depression affects approximately 10% of pregnant people and is associated with adverse parental and foetal outcomes. This bulletin presents antidepressant options during pregnancy.
The medicine information sheets for patients produced by the MyMedicines team at Te Whatu Ora Waitaha are undergoing a series of upgrades. After working with a national consumer focus group, a number of suggested changes are going to be made over the coming months. The first change is a new section in the sheets called…
Nausea and vomiting are common in pregnancy, affecting up to 80% of women. This bulletin summarises the available treatment options for these patients.
Nirmatrelvir+ritonavir (Paxlovid®) is available for patients with COVID-19 who are at high risk of severe disease. This bulletin provides recommendations for administration to patients who have enteral feeding tubes or swallowing difficulties.
The use of complementary and alternative products, e.g., herbal supplements, is very common however their use does not come without risk. Most products sold in Aotearoa NZ are unregulated and lack data to support their safety or efficacy. This patient information leaflet is to help patients weigh up any potential benefits of use against the…
Accuretic® (quinapril and hydrochlorothiazide 10/12.5 and 20/12.5 mg tablets) is being withdrawn and supplies will run out from August 2022. Patients will need to be switched to an alternative. Either: Switch to a separate ACE inhibitor and thiazide diuretic: Our recommendation is to replace this with perindopril and bendroflumethiazide. Quinapril tablets remain available and can…
Nirmatrelvir with ritonavir (Paxlovid®) is now available for patients with COVID-19 who are at high risk of severe disease. This bulletin discusses drug interactions that can occur with ritonavir, some of which may be potentially life-threatening. Further information on use of Paxlovid® can be found at: Ministry of Health – Therapeutics for the treatment of…
The use of complementary and alternative products (CAPs) such as herbals, dietary supplements, probiotics and homeopathic products is very common. However, most products sold in Aotearoa NZ are unregulated. This bulletin describes the problems reported regarding the quality of CAPs. CAP Quality
Antimicrobial resistance is a growing problem in Aotearoa New Zealand and globally it is a crisis. This year the focus of the Awareness Week is on improving the understanding for both health professionals and patients of penicillin allergy and the harms associated with incorrect allergy labelling. CDHB Antimicrobial Stewardship Committee has produced the following bulletins…
PHARMAC has an agreement with Arrotex NZ to supply prazosin tablets from 1st November 2021. This may leave a short gap in supply since local wholesalers estimate supply of 2 and 5 mg tablets will be depleted by late October (1 mg tablets are already out of stock). Pharmacies may need to ration amount supplied…
NZ is funding two medicines in new classes for the treatment of type 2 diabetes. See the following bulletin for key information on their use.
Oxazepam will no longer be available in New Zealand once current stocks are exhausted. This is expected to be from mid-October 2020 (10 mg tablets) to mid-November 2020 (15 mg tablets). See the notification from PHARMAC here. Oxazepam is a short-acting benzodiazepine, with a half-life of about 6 hours. For patients currently taking oxazepam: Consider…
Celiprolol tablets will no longer be available in New Zealand once current supplies are exhausted. See the notification from PHARMAC here. Celiprolol is a beta-blocker approved to treat hypertension and angina. For patients currently taking celiprolol, either: 1. Replace with an alternative beta-blocker: In most cases, we suggest the prescriber chooses the beta-blocker they are…
Supplies of phenelzine tablets will run out in New Zealand by the end of May 2020. See, Pharmac: Phenelzine sulfate discontinuation Guidance for withdrawal from phenelzine and switching to another antidepressant has been released in a joint statement from the New Zealand Hospital Pharmacists’ Association: Mental Health Special Interest Group and the Royal Australian &…
The COVID-19 pandemic has affected medicine supply globally. PHARMAC has provided a summary of all medicines where there is an issue with supply. We have included this link in the ‘Useful links’ section of our site, accessed from the ‘Resources’ tab at the top. It is also in the ‘Current supply’ section of our COVID-19…
Prescribing unapproved medicines is common in NZ. COVID-19 may increase our use of unapproved medicines as a result of either a change in supply, or the use of new medicines if appropriate evidence emerges. Medsafe outlines the responsibilities of prescribers using unapproved medicines. We have included a link in the ‘Useful links’ section of our…
Last edit: 23 May 2024 This page was developed to provide information for health professionals in NZ regarding medicines and COVID-19 during and immediately following the pandemic. It is no longer regularly updated. Please consult local HealthPathways or national guidelines for the management of COVID-19. For questions relating to specific patients please contact us via…
Did you know My Medicines now contains 66 patient information leaflets available in Te Reo Māori? Check them out here: https://www.mymedicines.nz/Home/TeReo or via the New Zealand Formulary: https://nzf.org.nz/nzf_70421
The current NZ Sanofi levomepromazine (Nozinan®) 25 mg and 100 mg tablets will be replaced with Swiss Sanofi Nozinan® formulations temporarily from 1st March 2020. They are not bioequivalent. Transition requires a review of the prescription for individual patients, and monitoring for altered clinical effect or toxicity. For more information, see our bulletin or www.medsafe.govt.nz.
Apo-Cilazapril/Hydrochlorothiazide® has been discontinued and supply in NZ is expected to run out by July 2020. We recommend all patients taking this product be reviewed and changed to an alternative treatment. From 1st March, prescriptions for existing patients will need to be annotated for funding. See PHARMAC guidance for more details. Cilazapril tablets are still…
estimated Glomerular Filtration Rate (eGFR; units mL/min/1.73m2) is often used in practice for determining renal function since it is readily available via lab results. It should be adjusted for body surface area in individuals with extremes of size. Alternatively, the Cockcroft-Gault formula (CrCl) can be used. For more background information, see: – recent MHRA article.…
The availability of ranitidine is extremely limited. Famotidine IV/oral is currently funded for hospital use, and 20 mg tablets will be fully funded in community from 1st January 2020 under Section 29 (unlicensed medicine). See Medsafe’s statement for more details on the product recall – https://www.medsafe.govt.nz/safety/Alerts/MedicinesAndNDMA.asp Alternative management options include: Gastroesophageal reflux disease (GORD):…
Two tricyclic antidepressants (TCAs), dosulepin (dothiepin) and doxepin will no longer be available in New Zealand. When transitioning patients to alternatives, consider: Is a TCA still appropriate? TCAs are associated with a higher risk of adverse outcomes in people with cardiovascular disease and older adults. Individual psychiatric history. Switching therapy increases the risk of relapse…
The Immunisation Advisory Centre have provided an information sheet about diseases and medications when live attenuated vaccines (e.g. MMR) may be contraindicated – See www.immune.org.nz or the PDF below. Health professionals are welcome to contact our service if unsure about any medicines. AdministrationImmunecompLiveVac20180507V02Final
Pregabalin is a gabapentinoid that is now fully funded and indicated as an option for patients with neuropathic pain, as well as focal seizures and generalised anxiety (unlicensed). Pregabalin may offer advantages over gabapentin in patients where adherence to a three-times-daily regimen is problematic or where gastrointestinal absorption may be impaired. The efficacy of gabapentinoids…