Medicine Recommendations

Treatment of severe osteoporosis

- in postmenopausal women;

- in adult men

at high risk of fracture, for whom treatment with other medicinal products approved for the treatment of osteoporosis is not possible due to, for example, contraindications or intolerance. In postmenopausal women, strontium ranelate reduces the risk of vertebral and hip fractures.

The decision to prescribe strontium ranelate should be based on an assessment of the individual patient's overall risks

MHRA Drug Safety Update - Strontium ranelate: cardiovascular risk—restricted indication and new monitoring requirements (March 2014)

For treating premenopausal women at high risk of breast cancer unless they have a past history or may be at increased risk of thromboembolic disease or endometrial cancer.

Secondary prevention of osteoporotic fragility fractures in postmenopausal women (NICE TA161) and men (NHSE policy)

NICE TA161: Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women

Female sexual dysfunction following post oophorectomy or primary ovarian failure

Testosterone replacement therapy for male hypogonadism when testosterone deficiency has been confirmed by clinical features and biochemical tests

As supplementation for menopausal women with low sexual desire if HRT alone is not effective.

Hypothyroidism

Managing overweight and obesity

Type 2 Diabetes (NICE TA924)

NICE TA924 - Tirzepatide for treating type 2 diabetes

Autosomal dominant polycystic kidney disease (NICE TA358)

NICE TA358 - Tolvaptan for treating autosomal dominant polycystic kidney disease

Treatment of hyponatremia in adults, secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), for patients not requiring chemotherapy.

Acute Gout (as per LSCMMG Guidelines)

For the management of foot ulcers in the diabetic population

Glucocorticoid-induced osteoporosis

NICE TA 464 - Bisphosphonates for treating osteoporosis

MHRA Drug Safety Update - Bisphosphonates: very rare reports of osteonecrosis of the external auditory canal

MHRA Drug Safety Update - Bisphosphonates: atypical femoral fractures

Osteoporosis (NICE TA464)

NICE TA 464 - Bisphosphonates for treating osteoporosis

MHRA Drug Safety Update - Bisphosphonates: very rare reports of osteonecrosis of the external auditory canal

MHRA Drug Safety Update - Bisphosphonates: atypical femoral fractures