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Your questions answered - October 2018

A selection of recent members’ questions that were answered by the NPA’s pharmacy services team.

 

Q: I have a generically written prescription for insulin as part 100units/ml solution for injection 3ml cartridges, which brand of insulin should I dispense against this?

A: Fiasp® Penfill and NovoRapid® Penfill®, both manufactured by Novo Nordisk Ltd, are two options for brands of insulin that may be dispensed against a generically written prescription for Insulin aspart solution for injection 100units/ml 3ml cartridges. Pharmacists should be aware that there are key differences between the two insulin products which include addition of nicotinamide, a more rapid onset of action, an increased post-meal glucose lowering effect and a faster initial absorption rate for Fiasp® Penfill compared to NovoRapid® Penfill®.

Before dispensing a generically written prescription for insulin as part, or other insulin products containing 100units/ ml or more of insulin (high-strength insulin), pharmacists and their teams should check the Insulin Passport (or safety card) to identify which specific brand of insulin the patient is using. All adult patients using high-strength, fixed combination or biosimilar insulin products should be issued with a patient booklet and Insulin Passport (or safety card) which carries a record of the patient’s current insulin products and allows a safety check for administration, dispensing and prescribing. Patients who should have an Insulin Passport (or safety card) but have not been provided with one can contact their doctor or diabetes nurse.

Q: Can I sell energy drinks to children under 16 years of age?

A: There is currently no legislation in place to restrict the sale of energy drinks containing caffeine to children.

However, before making a sale to a child under 16 years of age, the following points would need to be taken into consideration:

• The Food Standards Agency (FSA) has advised that children should only consume caffeine in moderation

• Children and adolescents can safely consume a maximum of 3mg/kg body weight of caffeine in a single dose or in a total daily dose

• Children and adolescents consuming 1.4mg/kg body weight of caffeine may experience an increase in the time it takes them to fall asleep, as well as decrease their sleep duration, especially when consumed near bedtime

• European Union (EU) regulations state that drinks with high caffeine levels (more than 150mg/l) must be labelled with “High caffeine content. Not recommended for children or pregnant or breast-feeding women”

• An EU review has stated that substituting energy drinks for soft drinks could result in changes in transient behaviour, such as, anxiety or nervousness, irritability and increased arousal

• Certain energy drinks may also have a high sugar content, which would contribute to the child’s or adolescent’s daily sugar intake.

Where a pharmacy stocks energy drinks, members of the pharmacy team must be aware of the points above, and any concerns should be raised with the pharmacist.

For further information contact the NPA on 01727 891800 or email pharmacyservices@npa.co.uk.

 

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