Pain Management


This report looks at prescribing trends in primary care in relation to Pain Management at ICB and Sub Integrated Board location (SICBl) with particular focus on Opioid and Non-opioid analgesics, Neuropathic pain, Antimigraine drugs and Osteoarthritis.

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Data Period

October 2020 to September 2023

Safer Medication Use – Opioids and gabapentinoids


Safer Medication Use is a bulletin series jointly produced by the Regional Drug and Therapeutics Centre and the Yellow Card Centre Northern and Yorkshire, which aims to promote safer prescribing. It discusses specific drug related safety problems, provides guidance to ensure safe, appropriate prescribing and raises awareness of adverse drug reaction detection and reporting.

The use of combination opioids and gabapentinoids is associated with an increased risk of adverse events. Gabapentinoid overdose is much more likely to be fatal when combined with opioids and there is a greater risk of gabapentinoid dependence in patients with a history of opioid use disorder.

There are limited circumstances when patients should be prescribed both an opioid and a gabapentinoid, and prescribers must carefully balance potential benefits against the risk of adverse effects from combination therapy. In such situations the opioid dose should be reduced before starting a gabapentinoid and the patient reviewed regularly. Treatment should be stopped if it is not effective or not tolerated but withdrawal of established opioids and / or gabapentinoid therapy should be done slowly to prevent discontinuation symptoms.

Postoperative patients who are prescribed long term gabapentinoids should be closely monitored for respiratory depression.

Levodopa inhalation powder for episodic motor fluctuations in Parkinson’s disease


New Drug Evaluations are concise, structured reviews of new drugs recently launched within the NHS. These documents seek to provide a brief overview of the efficacy, safety and cost of new drugs.

Inbrija®▼ (Acorda Therapeutics), a levodopa powder for oral inhalation, is licensed for the intermittent treatment of episodic motor fluctuations (OFF episodes) in adult patients with Parkinson’s disease (PD) treated with a levodopa/dopa-decarboxylase inhibitor.

This review is older than 18 months; in view of the continued emergence of new evidence, readers are recommended to re-check the biomedical literature.

Download the full review below to read more.

NICE has accredited the process used by the Regional Drug and Therapeutics Centre to produce New Drug Evaluations. Accreditation is valid until the 31st of December 2023.
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