MHRA March 2019

The latest update is here

The main drugs that may affect us in general practice are the use of Fluoroquinolones .

• Ciprofloxacin (Ciproxin) • Levofloxacin • Moxifloxacin (Avelox) • Ofloxacin (Tarivid)



New restricted indications Fluoroquinolones are antibiotics authorised for serious, life-threatening bacterial infections.

As for all antibiotic medicines, consideration should be given to official guidance on the appropriate use of antibacterial agents.

Following an EU-wide review of safety, new restricted indications are being introduced for fluoroquinolone antibiotics available in the UK. Please refer to the updated Summary of Product Characteristics before prescribing: • Ciprofloxacin (Ciproxin) • Levofloxacin • Moxifloxacin (Avelox) • Ofloxacin (Tarivid) Summaries of Product Characteristics will be updated in the coming weeks. In the meantime, see EMA document for exact changes made in indications.


The quinolone nalidixic acid was authorised for urinary tract infections, which is no longer a permitted indication. Therefore, the licence for nalidixic acid has been cancelled.


Fluoroquinolones should not be prescribed for treatment of mild to moderate infections (such as in acute exacerbation of chronic bronchitis and chronic obstructive pulmonary disease) unless other antibiotics that are commonly recommended for these infections are considered inappropriate. Relevant situations in which other antibiotics may be understood to be inappropriate are those in which there is resistance to the other first-line antibiotics recommended for these infections; when other first-line antibiotics cause side effects that lead to treatment being stopped or the other first-line antibiotics are contraindicated in an individual; or because first-line antibiotics have failed.


A search was done on our computer system to ensure non were on repeat.

Information will be passed on.

The other interesting article was about potential pregnancy and assessing this

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