{"id":3737,"date":"2025-03-27T10:55:42","date_gmt":"2025-03-27T10:55:42","guid":{"rendered":"https:\/\/nhsdorset.nhs.uk\/medicines\/?page_id=3737"},"modified":"2026-02-19T13:29:52","modified_gmt":"2026-02-19T13:29:52","slug":"low","status":"publish","type":"page","link":"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/pqs\/25-26\/low\/","title":{"rendered":"Medicines of low clinical value"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p><strong>Priority areas for the PQS for year 2 are:<\/strong><\/p>\n<ol>\n<li>Bath and shower preparations<\/li>\n<li>Dosulepin<\/li>\n<li>Doxazosin<\/li>\n<li>Liothyronine<\/li>\n<li>Minocycline<\/li>\n<\/ol>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\"><p><a href=\"https:\/\/www.england.nhs.uk\/publication\/items-which-should-not-routinely-be-prescribed-in-primary-care-policy-guidance\/\" target=\"_blank\" rel=\"noopener\">NHS England have produced a list of items which should no longer be prescribed<\/a> because they are:<\/p>\n<ul>\n<li>Not as safe as other medicines<\/li>\n<li>Not as good (effective) as other medicines<\/li>\n<li>More expensive than other medicines that do the same thing<\/li>\n<li>Shouldn\u2019t be available on the NHS in some circumstances<\/li>\n<\/ul>\n<p>As a result, NHS Dorset has asked that GP teams no longer prescribe the items listed below:<\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><ul style=\"--awb-line-height:40.8px;--awb-icon-width:40.8px;--awb-icon-height:40.8px;--awb-icon-margin:16.8px;--awb-content-margin:57.6px;--awb-circlecolor:var(--awb-color4);--awb-circle-yes-font-size:21.12px;\" class=\"fusion-checklist fusion-checklist-1 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Aliskerin<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Amiodarone (not to be initiated in primary care, can be prescribed in primary care if initiated by a hospital specialist)<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Bath and shower preparations<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Co-proxamol<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Doxazosin (prolonged release)<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Dronedarone (not to be initiated in primary care, can be prescribed in primary care if initiated by a hospital specialist)<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Glucosamine and chondroitin<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Herbal treatments and other natural products<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>High cost needles for pre-filled\/reusable insulin pens<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Homeopathy<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Immediate release fentanyl<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Lidocaine plasters<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Liothyronine<\/p>\n<\/div><\/li><\/ul><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><ul style=\"--awb-line-height:40.8px;--awb-icon-width:40.8px;--awb-icon-height:40.8px;--awb-icon-margin:16.8px;--awb-content-margin:57.6px;--awb-circlecolor:var(--awb-color4);--awb-circle-yes-font-size:21.12px;\" class=\"fusion-checklist fusion-checklist-2 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Lutein and antioxidants<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Minocycline for acne<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Omega-3 fatty acid compounds (excluding Icosapent ethyl [vazkepa\u00ae])<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Oxycodone and naloxone combination products<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Paracetamol and tramadol combination products<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Perindopril arginine<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Rubefacients<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Benzydamine<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Mucopolysaccharide and cooling products (excluding NSAIDs and capsaicin)<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Silk garments<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Travel vaccines<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-yes\"><i class=\"fusion-li-icon fa-angle-right fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>Trimipramine<\/p>\n<\/div><\/li><\/ul><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color2);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-three\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h3 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Priority areas for year 2 of the PQS are:<\/h3><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div ><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-1 fusion-button-span-yes fusion-button-default-type\" target=\"_self\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Bath and shower preparations<\/span><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div ><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-2 fusion-button-span-yes fusion-button-default-type\" target=\"_self\" href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/low\/#dosulepin\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Dosulepin <\/span><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_3 1_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:5.76%;--awb-width-medium:33.333333333333%;--awb-order-medium:0;--awb-spacing-right-medium:5.76%;--awb-spacing-left-medium:5.76%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div ><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-3 fusion-button-span-yes fusion-button-default-type\" target=\"_self\" href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/low\/#doxazosin\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Doxazosin<\/span><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div ><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-4 fusion-button-span-yes fusion-button-default-type\" target=\"_self\" href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/low\/#liothyronine\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Liothyronine<\/span><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-9 fusion_builder_column_1_2 1_2 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:3.84%;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:3.84%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div ><a class=\"fusion-button button-flat button-xlarge button-default fusion-button-default button-5 fusion-button-span-yes fusion-button-default-type\" target=\"_self\" href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/low\/#minocycline\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">Minocycline<\/span><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-10 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3\"><p><span class=\"ui-provider ee bre brf brg brh bri brj brk brl brm brn bro brp brq brr brs brt bru brv brw brx bry brz bsa bsb bsc bsd bse bsf bsg bsh bsi bsj bsk bsl\" dir=\"ltr\">The budget 25 26 and spend information pages within the DiiS can be used to identify potential savings opportunities and to track progress against the financial indicators.<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" id=\"bath\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-11 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Bath and shower preparations<\/h2><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-3737-1\"><div class=\"fusion-panel panel-default panel-5a7f1d2a17aad6faa fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_5a7f1d2a17aad6faa\"><a aria-expanded=\"false\" aria-controls=\"5a7f1d2a17aad6faa\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-1\" data-target=\"#5a7f1d2a17aad6faa\" href=\"#5a7f1d2a17aad6faa\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"5a7f1d2a17aad6faa\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_5a7f1d2a17aad6faa\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">Cease prescribing of bath and shower emollients for patients unless recommended by specialists for severe eczema or infants under the age of 1 year.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Advise patients with diagnosed dermatological conditions to use their usual emollient as a soap substitute in the bath or shower, as per guidance below.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Advise patients to purchase products from a pharmacy if they want to continue using a bath and shower emollient.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-d2eb0ec25203266ec fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_d2eb0ec25203266ec\"><a aria-expanded=\"false\" aria-controls=\"d2eb0ec25203266ec\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-1\" data-target=\"#d2eb0ec25203266ec\" href=\"#d2eb0ec25203266ec\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"d2eb0ec25203266ec\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_d2eb0ec25203266ec\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">These products are included in the<\/span><span data-contrast=\"none\">\u00a0NHSE drugs of low clinical value and should not be prescribed.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The clinical rationale comes from the paediatric study, BATHE. Over the period of one year, no advantage was identified to using a specific bath emollient compared to using their usual leave-on emollient to wash with. In most patient cases, the eczema improved in both study groups. There is also a higher risk of falls in the bath for those who use bath emollients<\/span><span data-contrast=\"none\">.\u00a0\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-84a59c74518fa469d fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_84a59c74518fa469d\"><a aria-expanded=\"false\" aria-controls=\"84a59c74518fa469d\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-1\" data-target=\"#84a59c74518fa469d\" href=\"#84a59c74518fa469d\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"84a59c74518fa469d\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_84a59c74518fa469d\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">Run the SystmOne search provided to identify the patients who are receiving these items on prescription. <\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Communicate the changes to patients involved.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Share relevant resources with the patient.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-ca773c4b24d21ac1b fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_ca773c4b24d21ac1b\"><a aria-expanded=\"false\" aria-controls=\"ca773c4b24d21ac1b\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-1\" data-target=\"#ca773c4b24d21ac1b\" href=\"#ca773c4b24d21ac1b\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"ca773c4b24d21ac1b\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_ca773c4b24d21ac1b\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"ui-provider ne bdl bdm bdn bdo bdp bdq bdr bds bdt bdu bdv bdw bdx bdy bdz bea beb bec bed bee bef beg beh bei bej bek bel bem ben beo bep beq ber bes\" dir=\"ltr\">SystmOne search: Dorset SystmOne GPs\/PQS Finance 25 26\/F7 Medicines of low clinical value\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Template patient text message:<\/span><\/p>\n<p><span data-contrast=\"auto\">\u201c<\/span><i><span data-contrast=\"auto\">NHS Dorset has asked all GP teams to review prescribing of all bath and shower emollients. There is no clinical benefit in using these products over standard leave-on emollients as soap substitutes. The NHS recommends that these should not be routinely prescribed and your prescription has been stopped. Bath and shower emollients are available to buy from most supermarkets and pharmacies if you would like to continue with this treatment. If you would like to discuss this change further, please contact the surgery.\u201d<\/span><\/i><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/view.officeapps.live.com\/op\/view.aspx?src=https%3A%2F%2Fnhsdorset.nhs.uk%2Fwp-content%2Fuploads%2F2025%2F12%2FTemplate-Patient-Letter-Bath-and-shower-emollients.doc&amp;wdOrigin=BROWSELINK\"><span data-contrast=\"auto\">Template patient letter \u2013 bath &amp; shower emollients<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2024\/04\/Emollients-PIL.docx\">Patient information leaflet<\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/Patient-information-leaflet-Using-emollients-as-soap-substitutes.pdf\"><span data-contrast=\"auto\">Patient leaflet \u2013 using emollients (moisturisers) as soap substitutes<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/PrescQIPP-emollients-briefing.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Emollients Briefing (PrescQIPP)<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/PrescQIPP-emollients-bulletin.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Emollients Bulletin (PrescQIPP)<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/b244-bath-and-shower-emollients-20.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Bath and Shower Emollients Bulletin (PrescQIPP)<\/span><\/a><\/p>\n<p><a href=\"https:\/\/www.england.nhs.uk\/publication\/items-which-should-not-routinely-be-prescribed-in-primary-care-policy-guidance\/\" target=\"_blank\" rel=\"noopener\">NHS England have produced a list of items which should no longer be prescribed<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color2);--awb-flex-wrap:wrap;\" id=\"dosulepin\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-12 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Dosulepin<\/h2><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-3737-2\"><div class=\"fusion-panel panel-default panel-502ac5051f4ba05dc fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_502ac5051f4ba05dc\"><a aria-expanded=\"false\" aria-controls=\"502ac5051f4ba05dc\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-2\" data-target=\"#502ac5051f4ba05dc\" href=\"#502ac5051f4ba05dc\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"502ac5051f4ba05dc\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_502ac5051f4ba05dc\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TextRun SCXW244884947 BCX9\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW244884947 BCX9\">Identify patients prescribed\u00a0<\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW244884947 BCX9\">dosulepin<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">\u00a0and through a shared decision<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">\u2013<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">making process,\u00a0<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">switch to\u00a0<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">an\u00a0<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">alternative antidepressant<\/span><span class=\"NormalTextRun SCXW244884947 BCX9\">\u00a0if possible.<\/span><\/span><span class=\"EOP SCXW244884947 BCX9\" data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-933d096e46c5f4a1a fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_933d096e46c5f4a1a\"><a aria-expanded=\"false\" aria-controls=\"933d096e46c5f4a1a\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-2\" data-target=\"#933d096e46c5f4a1a\" href=\"#933d096e46c5f4a1a\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"933d096e46c5f4a1a\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_933d096e46c5f4a1a\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TextRun SCXW262626567 BCX9\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"auto\"><span class=\"NormalTextRun SpellingErrorV2Themed SpellingErrorHighlight SCXW262626567 BCX9\">Dosulepin<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">\u00a0(previously,\u00a0<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">dothiepin<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">)<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">\u00a0is a tricyclic antidepressant.\u00a0<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">The National Institute of Health &amp; Care Excellence (NI<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">C<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">E) advises\u00a0<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">\u201cdo not switch to, or start<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">,\u00a0<\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW262626567 BCX9\">dosulepin<\/span><span class=\"NormalTextRun SCXW262626567 BCX9\">\u00a0because evidence supporting its tolerability relative to other antidepressants is outweighed by the increased cardiac risk and toxicity in overdose.\u201d<\/span><\/span><span class=\"EOP SCXW262626567 BCX9\" data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-dd7ed3f8f8925557a fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_dd7ed3f8f8925557a\"><a aria-expanded=\"false\" aria-controls=\"dd7ed3f8f8925557a\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-2\" data-target=\"#dd7ed3f8f8925557a\" href=\"#dd7ed3f8f8925557a\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"dd7ed3f8f8925557a\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_dd7ed3f8f8925557a\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">Identify patients using the SystmOne search provided.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Contact patients affected and invite them for review.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Review and switch to a suitable alternative where possible.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-5b5b4357a2fb913c4 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_5b5b4357a2fb913c4\"><a aria-expanded=\"false\" aria-controls=\"5b5b4357a2fb913c4\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-2\" data-target=\"#5b5b4357a2fb913c4\" href=\"#5b5b4357a2fb913c4\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"5b5b4357a2fb913c4\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_5b5b4357a2fb913c4\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TrackChangeTextInsertion TrackedChange SCXW200163964 BCX8\"><span class=\"TextRun SCXW200163964 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW200163964 BCX8\">SystmOne<\/span><\/span><\/span><span class=\"TrackChangeTextInsertion TrackedChange SCXW200163964 BCX8\"><span class=\"TextRun SCXW200163964 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW200163964 BCX8\">\u00a0search:\u00a0<span class=\"ui-provider ne bdl bdm bdn bdo bdp bdq bdr bds bdt bdu bdv bdw bdx bdy bdz bea beb bec bed bee bef beg beh bei bej bek bel bem ben beo bep beq ber bes\" dir=\"ltr\">Dorset SystmOne GPs\/PQS Finance 25 26\/F7 Medicines of\u00a0 low clinical value\u00a0<\/span><\/span><\/span><\/span><\/p>\n<p><span data-contrast=\"auto\">Template patient text message:<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">\u201cWe are writing to all the patients currently prescribed dosulepin, to encourage them to make an appointment to discuss an alternative treatment. The reason for this is that there are some safety concerns with dosulepin and there may be a more suitable and safer drug that the practice can offer you.\u00a0<\/span><\/i><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">We appreciate that changing antidepressant therapy may cause concern for some patients, however we are committed to the safe use of medicines and providing the best healthcare for our patients.\u00a0<\/span><\/i><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><i><span data-contrast=\"auto\">Please make an appointment at the surgery at a convenient time to discuss this further.\u201d<\/span><\/i><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/view.officeapps.live.com\/op\/view.aspx?src=https%3A%2F%2Fnhsdorset.nhs.uk%2Fwp-content%2Fuploads%2F2025%2F12%2FTemplate-Patient-Letter-Dosulepin-invitation.docx&amp;wdOrigin=BROWSELINK\"><span class=\"ui-provider gp b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\" dir=\"ltr\">Template patient letter<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/Safety-bulletin-Dosulepin-final-2021.pdf\"><span data-contrast=\"auto\">NHS Dorset safety bulletin: dosulepin prescribing<\/span><\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-6 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" id=\"doxazosin\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-13 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Doxazosin (prolonged release)<\/h2><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-3737-3\"><div class=\"fusion-panel panel-default panel-ddc1380e30c4cf098 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_ddc1380e30c4cf098\"><a aria-expanded=\"false\" aria-controls=\"ddc1380e30c4cf098\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-3\" data-target=\"#ddc1380e30c4cf098\" href=\"#ddc1380e30c4cf098\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"ddc1380e30c4cf098\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_ddc1380e30c4cf098\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TextRun SCXW204892559 BCX9\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW204892559 BCX9\">Identify\u00a0<\/span><span class=\"NormalTextRun SCXW204892559 BCX9\">prescriptions for modified release (MR) doxazosin tablets\u00a0<\/span><span class=\"NormalTextRun SCXW204892559 BCX9\">and move\u00a0<\/span><span class=\"NormalTextRun SCXW204892559 BCX9\">to standard release tablets<\/span><span class=\"NormalTextRun SCXW204892559 BCX9\">.<\/span><\/span><span class=\"EOP SCXW204892559 BCX9\" data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-6089e2c57dd71bb04 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_6089e2c57dd71bb04\"><a aria-expanded=\"false\" aria-controls=\"6089e2c57dd71bb04\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-3\" data-target=\"#6089e2c57dd71bb04\" href=\"#6089e2c57dd71bb04\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"6089e2c57dd71bb04\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_6089e2c57dd71bb04\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">MR d<\/span><span data-contrast=\"none\">oxazosin tablets are approximately five times the cost of immediate release tablets and yet offer no discernible benefits.<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-32fb11ea65e973f67 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_32fb11ea65e973f67\"><a aria-expanded=\"false\" aria-controls=\"32fb11ea65e973f67\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-3\" data-target=\"#32fb11ea65e973f67\" href=\"#32fb11ea65e973f67\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"32fb11ea65e973f67\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_32fb11ea65e973f67\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">Use the SystmOne search provided to identify repeat prescriptions for MR tablets and change to standard release tablets as per guidance provided.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Communicate the changes to patients involved.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">SystmOne has been updated so that initiations of doxazosin MR will be directed to doxazosin immediate release tablets.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-79ad7002c31c097e3 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_79ad7002c31c097e3\"><a aria-expanded=\"false\" aria-controls=\"79ad7002c31c097e3\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-3\" data-target=\"#79ad7002c31c097e3\" href=\"#79ad7002c31c097e3\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"79ad7002c31c097e3\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_79ad7002c31c097e3\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"ui-provider ne bdl bdm bdn bdo bdp bdq bdr bds bdt bdu bdv bdw bdx bdy bdz bea beb bec bed bee bef beg beh bei bej bek bel bem ben beo bep beq ber bes\" dir=\"ltr\">SystmOne search: Dorset SystmOne GPs\/PQS Finance 25 26\/F7 Medicines of low clinical value\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2024\/04\/Template-Patient-Letter-doxazosin-formulation.docx\" target=\"_blank\" rel=\"noopener\">Template patient letter<\/a><\/p>\n<p><span data-contrast=\"auto\">Template patient text message:<\/span><\/p>\n<p><i><span data-contrast=\"auto\">\u201cNHS Dorset has asked all GP teams to prescribe doxazosin as immediate release tablets, rather than the modified release tablets. They offer the same health benefits but help the NHS budget to go further.\u00a0 We have updated your prescription as discussed but if you have any concerns, please contact the surgery.\u201d<\/span><\/i><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.sps.nhs.uk\/articles\/switching-from-doxazosin-xl-tablets-to-doxazosin-standard-release-tablets\/?UNLID=2250147272023322104247\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">Specialist Pharmacy Service (SPS) switching doxazosin XL tablets to standard release tablets<\/span><\/a><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/Doxazosin-bulletin.pdf\"><span data-contrast=\"auto\">Prescqipp doxazosin modified release tablets bulletin<\/span><\/a><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/12\/Doxazosin-patient-information.pdf\"><span data-contrast=\"none\">Patient leaflet \u2013 Doxazosin products<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/a><\/p>\n<p>References:<\/p>\n<ol>\n<li data-leveltext=\"%1.\" data-font=\"Calibri\" data-listid=\"22\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\"><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng136\" target=\"_blank\" rel=\"noopener\">NICE NG136 (Hypertension in adults: diagnosis and management)<\/a>\u00a0and\u00a0<a href=\"https:\/\/www.nice.org.uk\/Guidance\/CG97\" target=\"_blank\" rel=\"noopener\">NICE CG97 (Lower urinary tract symptoms in men: management): neither documents identify benefits of modified-release above immediate release.<\/a><\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.england.nhs.uk\/publication\/items-which-should-not-routinely-be-prescribed-in-primary-care-policy-guidance\/\" target=\"_blank\" rel=\"noopener\">NHS England have produced a list of items which should no longer be prescribed<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-7 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color2);--awb-flex-wrap:wrap;\" id=\"liothyronine\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-14 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Liothyronine<\/h2><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-3737-4\"><div class=\"fusion-panel panel-default panel-cb4490058d78104cf fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_cb4490058d78104cf\"><a aria-expanded=\"false\" aria-controls=\"cb4490058d78104cf\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-4\" data-target=\"#cb4490058d78104cf\" href=\"#cb4490058d78104cf\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"cb4490058d78104cf\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_cb4490058d78104cf\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">Adopt the Dorset position statement on liothyronine use for thyroid hormone replacement, namely:<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Refer existing users of liothyronine (indicated for thyroid hormone replacement) to secondary care endocrinology specialists for review.*<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Decline to prescribe for new liothyronine patients (indicated for thyroid hormone replacement) if initiated by private referrals or Dorset NHS clinicians.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" data-list-defn-props=\"{\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Only support new initiations of liothyronine (indicated for thyroid hormone replacement) if requested from a non-Dorset NHS endocrine specialist service and supported by a comprehensive shared care agreement.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">*While waiting for specialist endocrinology review of existing patients, update prescriptions of tablets to capsule formulations. The tablets and capsules are clinically interchangeable but the capsules are significantly more cost effective.\u00a0 Full details here: <\/span><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/value\/formulation\/#liothyronine\"><span data-contrast=\"none\">Formulation\/Presentation Changes \u2013 Medicines Optimisation (nhsdorset.nhs.uk)<\/span><\/a><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-a62810a82a0c1b552 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_a62810a82a0c1b552\"><a aria-expanded=\"false\" aria-controls=\"a62810a82a0c1b552\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-4\" data-target=\"#a62810a82a0c1b552\" href=\"#a62810a82a0c1b552\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"a62810a82a0c1b552\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_a62810a82a0c1b552\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\">NHS England has highlighted that prescribing of liothyronine &amp; thyroid extract products is not predominantly appropriate because of safety concerns and limited clinical effectiveness.\u00a0 This position is supported by Dorset NHS Endocrinology specialists.\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Interim formulation review will help the Dorset NHS pound go further, and care for a greater number of patients.<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-c340a7ee82693581e fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_c340a7ee82693581e\"><a aria-expanded=\"false\" aria-controls=\"c340a7ee82693581e\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-4\" data-target=\"#c340a7ee82693581e\" href=\"#c340a7ee82693581e\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"c340a7ee82693581e\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_c340a7ee82693581e\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"TextRun SCXW55032421 BCX8\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW55032421 BCX8\">Run the <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW55032421 BCX8\">SystmOne<\/span><span class=\"NormalTextRun SCXW55032421 BCX8\"> search provided to <\/span><span class=\"NormalTextRun SCXW55032421 BCX8\">identify<\/span><span class=\"NormalTextRun SCXW55032421 BCX8\"> the patients who are receiving liothyronine &amp; thyroid extract products on repeat prescription <\/span><span class=\"NormalTextRun SCXW55032421 BCX8\">for thyroid hormone replacement <\/span><span class=\"NormalTextRun SCXW55032421 BCX8\">&amp; <\/span><span class=\"NormalTextRun SCXW55032421 BCX8\">refer to secondary care endocrinology specialists as per the NHS Dorset position statement.\u00a0<\/span><\/span><span class=\"EOP SCXW55032421 BCX8\" data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-28a0b782fe8225285 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_28a0b782fe8225285\"><a aria-expanded=\"false\" aria-controls=\"28a0b782fe8225285\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-4\" data-target=\"#28a0b782fe8225285\" href=\"#28a0b782fe8225285\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"28a0b782fe8225285\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_28a0b782fe8225285\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span data-contrast=\"auto\"><span class=\"ui-provider ne bdl bdm bdn bdo bdp bdq bdr bds bdt bdu bdv bdw bdx bdy bdz bea beb bec bed bee bef beg beh bei bej bek bel bem ben beo bep beq ber bes\" dir=\"ltr\">SystmOne search: Dorset SystmOne GPs\/PQS Finance 25 26\/F7 Medicines of low clinical value\u00a0<\/span><\/span><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/wp-content\/uploads\/2025\/11\/Liothyronine-Position-Statement-2025_05_23v5-1.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"auto\">Dorset Liothyronine position statement\u00a0<\/span><span data-ccp-props=\"{\">\u00a0<\/span><\/a><\/p>\n<p><span data-ccp-props=\"{\">\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-8 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" id=\"minocycline\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1310.4px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-15 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-text fusion-title-size-two\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h2 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\"><span class=\"ui-provider gl ckq ckr cks ckt cku ckv ckw ckx cky ckz cla clb clc cld cle clf clg clh cli clj clk cll clm cln clo clp clq clr cls clt clu clv clw clx\" dir=\"ltr\">Minocycline for acne<\/span><\/h2><\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:18px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:var(--awb-color5);--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);--awb-icon-box-color:var(--awb-color5);--awb-toggle-hover-accent-color:var(--awb-color4);--awb-toggle-active-accent-color:var(--awb-color4);--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-content-font-family:var(--awb-typography4-font-family);--awb-content-font-weight:var(--awb-typography4-font-weight);--awb-content-font-style:var(--awb-typography4-font-style);\"><div class=\"panel-group fusion-toggle-icon-unboxed\" id=\"accordion-3737-5\"><div class=\"fusion-panel panel-default panel-2f87929071acb17c9 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_2f87929071acb17c9\"><a aria-expanded=\"false\" aria-controls=\"2f87929071acb17c9\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-5\" data-target=\"#2f87929071acb17c9\" href=\"#2f87929071acb17c9\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What are you asking me to do?<\/span><\/a><\/h4><\/div><div id=\"2f87929071acb17c9\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_2f87929071acb17c9\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"ui-provider gl ckq ckr cks ckt cku ckv ckw ckx cky ckz cla clb clc cld cle clf clg clh cli clj clk cll clm cln clo clp clq clr cls clt clu clv clw clx\" dir=\"ltr\">Identify all repeat primary care prescriptions for minocycline prescribed for acne, and cease prescribing. (Minocycline is on the Dorset formulary as a RED drug and can be prescribed from secondary care, as an option for acne treatment in patients who suffer with mood problems when using isotretinoin for acne). \u00a0<\/span><\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-c39472fa7f6ac7a2d fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_c39472fa7f6ac7a2d\"><a aria-expanded=\"false\" aria-controls=\"c39472fa7f6ac7a2d\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-5\" data-target=\"#c39472fa7f6ac7a2d\" href=\"#c39472fa7f6ac7a2d\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Why are you asking me to do this?<\/span><\/a><\/h4><\/div><div id=\"c39472fa7f6ac7a2d\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_c39472fa7f6ac7a2d\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>NHS England has identified this drug for this indication as something which should not be initiated, and where in use, should be deprescribed.<\/p>\n<p>NICE guidance on acne vulgaris management advises: \u201cMinocycline is not recommended for use in acne as it is associated with an increased risk of adverse effects such as drug-induced lupus, skin pigmentation and hepatitis.\u201d<\/p>\n<p>The Dorset Formulary states: Minocycline can cause gastrointestinal and dermatological adverse reactions. It has also been associated with hyperpigmentation and systemic lupus erythematosus (SLE) and autoimmune hepatitis. The BNF advises that if treatment continues beyond six months, GPs should monitor patients every three months for hepatotoxicity, pigmentation and SLE.<\/p>\n<p>A PrescQIPP CIC review found no evidence to support the use of one tetracycline over another in terms of efficacy for the treatment of acne vulgaris, and alternative once daily products are available.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-7746b8d27c7d547f0 fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_7746b8d27c7d547f0\"><a aria-expanded=\"false\" aria-controls=\"7746b8d27c7d547f0\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-5\" data-target=\"#7746b8d27c7d547f0\" href=\"#7746b8d27c7d547f0\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">How do I do it?<\/span><\/a><\/h4><\/div><div id=\"7746b8d27c7d547f0\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_7746b8d27c7d547f0\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p>Use the SystmOne search provided to identify repeat prescriptions for minocycline for acne. Deprescribe and communicate the changes to patients involved.<\/p>\n<\/div><\/div><\/div><div class=\"fusion-panel panel-default panel-1dca583b0c8caff3d fusion-toggle-no-divider fusion-toggle-boxed-mode\" style=\"--awb-title-color:var(--awb-color5);--awb-content-color:var(--awb-custom_color_1);\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_1dca583b0c8caff3d\"><a aria-expanded=\"false\" aria-controls=\"1dca583b0c8caff3d\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-3737-5\" data-target=\"#1dca583b0c8caff3d\" href=\"#1dca583b0c8caff3d\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon fa-pills fas\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">What resources\/support is provided to help me deliver this?<\/span><\/a><\/h4><\/div><div id=\"1dca583b0c8caff3d\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_1dca583b0c8caff3d\"><div class=\"panel-body toggle-content fusion-clearfix\">\n<p><span class=\"ui-provider ne bdl bdm bdn bdo bdp bdq bdr bds bdt bdu bdv bdw bdx bdy bdz bea beb bec bed bee bef beg beh bei bej bek bel bem ben beo bep beq ber bes\" dir=\"ltr\">SystmOne search: Dorset SystmOne GPs\/PQS Finance 25 26\/F7 Medicines of low clinical value\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2024\/04\/Template-Patient-Letter-Minocycline.docx\">Template patient letter<\/a><\/p>\n<p>Template patient text message:<\/p>\n<p>\u201cWe are writing to all the patients currently prescribed minocycline for acne. NHS England has asked all GPs to cease prescribing as there are some safety concerns with minocycline and there may be more suitable therapeutic approaches that the practice can offer you. We have stopped your current prescription, but please make an appointment at the surgery at a convenient time to discuss this further should you need further support.\u201d<\/p>\n<p><a href=\"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-content\/uploads\/sites\/3\/2024\/04\/Minocycline-PIL.docx\">Patient information leaflet<\/a><\/p>\n<p><span class=\"ui-provider gl ckq ckr cks ckt cku ckv ckw ckx cky ckz cla clb clc cld cle clf clg clh cli clj clk cll clm cln clo clp clq clr cls clt clu clv clw clx\" dir=\"ltr\"><a class=\"fui-Link ___1rxvrpe f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1hu3pq6 f11qmguv f19f4twv f1tyq0we f1g0x7ka fhxju0i f1qch9an f1cnd47f fqv5qza f1vmzxwi f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/www.nice.org.uk\/guidance\/ng198\/chapter\/recommendations\" href=\"https:\/\/www.nice.org.uk\/guidance\/ng198\/chapter\/Recommendations\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link NICE NG198: Acne vulgaris: management\">NICE NG198: Acne vulgaris: management<\/a><\/span><\/p>\n<p><a href=\"https:\/\/www.england.nhs.uk\/publication\/items-which-should-not-routinely-be-prescribed-in-primary-care-policy-guidance\/\" target=\"_blank\" rel=\"noopener\">NHS England have produced a list of items which should no longer be prescribed<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":3699,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-3737","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3737","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/comments?post=3737"}],"version-history":[{"count":18,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3737\/revisions"}],"predecessor-version":[{"id":4359,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3737\/revisions\/4359"}],"up":[{"embeddable":true,"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/pages\/3699"}],"wp:attachment":[{"href":"https:\/\/nhsdorset.nhs.uk\/medicines\/wp-json\/wp\/v2\/media?parent=3737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}