Recommended across the site

This article discusses different mechanisms of drug interactions. We link to other SPS articles to help support decision making.
It is important to understand the risks, mechanisms of interactions and actions to take when prescribing medicines with DOACs.
Interactions with apixaban, dabigatran, edoxaban or rivaroxaban can result in increased risks of a bleed or thrombosis. We advise on management options.
Guidance on frequently asked questions on medicine interactions with low dose methotrexate.
Advice on whether refrigerated medicines can or can’t be used after exposure to out-of-range temperatures. Find entries and build and print lists.
The availability of medicines used to treat Attention Deficit Hyperactivity Disorder (ADHD) varies currently. Supply content is maintained regularly by DHSC.
Natalizumab biosimilar needs planning. Ensure you are familiar with the area and then develop an implementation plan working with the multidisciplinary team.
One licensed natalizumab biosimilar is available: Tyruko. Learn about the licensed indications and supporting evidence.
Practice points to ensure good governance when planning or designing vaccination services where multiple vaccines are used.
A Template Technical Agreement for outsourcing the Receipt, Storage, Preparation and Onward Supply of ATIMPs for Clinical Trial Sites
Practical advice for centres implementing Gene Therapies detailing Governance requirements and optimal preparation location decision making support.
St Mark’s solution is an oral rehydration solution, which maintains fluid balance in conditions like short bowel syndrome. We guide on preparation and use.

Recommended in PGDs

A step by step guide to help organisations and individuals navigate all stages of the PGD development process
Understand what a Patient Group Direction (PGD) is and how it is used in clinical practice.
Understanding when PGDs are a suitable mechanism for the supply and/or administration of medicines ensures an appropriate legal framework for service provision.
Understanding when PGDs are an unsuitable mechanism for the supply and/or administration of medicines ensures an alternative legal framework is applied.
Understanding where PGDs can and cannot be used for the supply and/or administration of P and GSL medicines helps ensure correct legal mechanisms in practice.
National PGD templates are developed with experts for clinical specialties. They reduce duplication and variation, and improve consistency of care.

Recommended in breastfeeding

All our training and guidance to help decision making about the use of medicines in breastfeeding
Ibuprofen or diclofenac are the non-steroidal anti-inflammatory drugs (NSAID) of choice. Recommendations apply to full term and healthy infants.
Nitrofurantoin can be used during breastfeeding. Recommendations apply to full term and healthy infants.
Lorazepam and oxazepam are the preferred benzodiazepines during breast feeding, if clinically appropriate. Recommendations apply to full term, healthy infants.
All penicillin antibiotics can be used during breastfeeding with precautionary infant monitoring. Recommendations apply to full term, healthy infants.
Metronidazole can be used during breastfeeding for most usual treatment courses. Recommendations apply to full term, healthy infants.
Aciclovir or valaciclovir can be used during breastfeeding. Recommendations apply to full term and healthy infants.
Low molecular weight heparin and unfractionated heparin can be used during breastfeeding. Recommendations apply to full term, healthy infants only.

Events

Our forthcoming conferences and webinars covering a range of Medicines Optimisation issues with SPS and other great speakers and presenters.
Search our library of past events for recordings, presentations, and interviews with speakers, all to inform your practice.

Primary care

Our primary care resources and tools are for all those working in the area, including GPs, practice pharmacists and community pharmacy teams.

If you're a healthcare professional who needs further advice, get in touch with us. You can contact us through our single email or telephone number below. Please don't share patient identifiable data with us by email.
All our advice on using medicines safely and effectively in patients with swallowing difficulties
All our training and guidance to help decision making about the use of medicines in breastfeeding
All our training and guidance to help decision making about the use of medicines in pregnancy
All vaccinations, including live vaccines, can be given during breastfeeding. The only exception is yellow fever vaccine which is not recommended.
Continue breastfeeding during COVID-19 infection, even if dexamethasone, Paxlovid, sotrovimab or tocilzumab are required. COVID-19 vaccines can also be given.
An overview of the Comirnaty 3 (THREE) (XBB.1.5) concentrate vaccine and signposts to other useful resources.
An example SOP for preparing Comirnaty 3 (THREE) (XBB.1.5) concentrate vaccine.
An overview of the Spikevax (XBB.1.5) vaccine and signposts to other useful resources.
An example SOP for preparing Spikevax (XBB.1.5) vaccine.
An example SOP for preparing Comirnaty 10 (XBB.1.5) ready to use vaccine.
An overview of the Comirnaty 10 (XBB.1.5) ready to use vaccine and signposts to other useful resources.
Continue breastfeeding during COVID-19 infection, even if dexamethasone, Paxlovid, sotrovimab or tocilzumab are required. COVID-19 vaccines can also be given.
Support for prescribing decisions in people on interacting medicines, those with swallowing difficulties, renal impairment, or who are pregnant or breastfeeding
Differing models exist for the supply and administration of COVID-19 treatments. We guide through the risks and mitigations associated with each.
Deployment should address a range of factors and be implemented through different mechanisms. Collecting data and learning will support continued safe use.
An outline process and supporting materials to help Trusts deploy sotrovimab
A careful risk assessment should be done on the benefits of this off-label use to the mother, and the risks it poses to the fetus or neonate.
Guidance for Chief Pharmacists and supporting documents to achieve Institutional Readiness and deployment of COVID-19 Treatments
Medication Safety Across the System (MSATS) provides resources and networking to inspire and equip individuals in promoting the safe use of medicines.
Practical guidance on effective collaboration opportunities to promote medication safety improvements
Effective communication allows for timely responses to new and emerging medication risks and the sharing of potential safety solutions.
Healthcare professionals responsible for medication safety in their organisation must deliver an appropriate response to safety alerts
High quality reporting and management of incidents and harms ensures opportunities for learning and improving medication safety
Practical guidance to ensure opportunities to learn from local intelligence, including patient harm are translated into shared local and national learning
Healthcare professionals delivering the medication safety agenda in their organisation require an understanding of national policy, frameworks and legislation
Effective use provides assurance that an organisation is aware of the most critical medication safety related information, and acts on this to improve safety
Increased medication incident reporting provides greater opportunities for learning and improving medication safety
Practical guidance to support those undertaking medication incident investigations

Planning

Our annual Prescribing Outlook outputs support planning, implementation and budget planning for medicines every year.
Regularly updated material to support the introduction of adalimumab, eculizumab, natalizumab, ranibizumab and tocilizumab biosimilars.

Tools

Summarised recommendations and guidance for medicines requiring monitoring to save you time when you're making monitoring decisions with patients
Latest information on supply issues, actions to take, alternatives to use, and expected resolution dates. Content provided by DHSC and CMU.
Information on stability for tablets and capsules to help create MCAs for patients. Find entries and then build and print lists specific to your MCA.
Advice on whether refrigerated medicines can or can’t be used after exposure to out-of-range temperatures. Find entries and build and print lists.