Leyla Hannbeck, head of pharmacy at the National Pharmacy Association, answers three of the 700 questions fielded every day by the NPA’s Pharmacy Services team

Question

There is currently a supply problem with Betnovate, Eumovate and Dermovate cream and ointment formulations. Is there an alternative?

Answer

The choice of a topical corticosteroid is dependent on
various factors, for example:

• Age of the patient
• Clinical indication
• Whether it is being sold over the counter or prescribed
• The licensed indication of the product.There are alternative topical corticosteroids available, but they vary in potency. They include:
• Mild – Dioderm, hydrocortisone 0.1-2.5 per cent, Synalar 1 in 10 Dilution
• Moderate – Haelan, Modrasone, Synalar 1 in 4 Dilution, Ultralanum Plain
• Potent – beclometasone dipropionate 0.025 per cent, Cutivate, Diprosone, Elocon, hydrocortisone butyrate, Locoid, Metosyn, Mometasone furoate 0.1 per cent, Nerisone, Synalar
• Very potent – Nerisone Forte. The choice of corticosteroid is a clinical decision for the prescriber.

Question

What is the recommended dose of naproxen for the treatment of migraine?

Answer

Naproxen can be used for the treatment of migraine at a single dose of 750mg to 825mg, followed by a further 250mg to 275mg up to twice in 24 hours (if required). Although naproxen can be considered for the treatment of migraine there is generally less evidence and experience to support its use

Question

Are gauze swabs type 13 light BP, sterile or non-sterile, allowed on NHS prescription?

Answer

The following gauze swabs type 13 light BP, sterile or non-sterile, are allowed on NHS prescription as they are listed in the appliances sections of the current drug tariffs – Part IXA of the England and Wales Drug Tariff; Part 2 of the Scottish Drug Tariff and Part III of the Northern Ireland Drug Tariff:

• Sterile 8-ply gauze 7.5x7.5cm – allowed on FP10/WP10, GP10, HS21
• Non-sterile 8-ply gauze 10x10cm – allowed on FP10/WP10, GP10, HS21
• Non-sterile 12-ply gauze 7.5x7.5cm – allowed on GP10
• Non-sterile 12-ply gauze 10x10cm – allowed on GP10.