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Dosing instructions

From Mr J. Shah, MRPharmS

Recently, I received a text message from a friend: “I’ve got to take Avamys spray for hay fever. Leaflet says once a day, two sprays in both nostrils. Sticker on front of box says use twice a day as directed by the doctor. So does that mean two sprays in both nostrils twice a day or one spray in both nostrils twice a day? And the doctor didn’t give me any directions on how to use.”

I replied saying that the summary of product characteristics states two sprays in each nostril once daily. Once adequate control of symptoms is achieved, reduce the dose to one spray in each nostril. I explained that twice daily seems an error on the GP’s part.

Reflecting on this incident, I thought perhaps the GP and the community pharmacist who dispensed the medicine are unaware that Avamys is recommended to be used once daily.

The “Medicines, ethics and practice” guide (July 2012) states that pharmacists can substitute the instructions given on the prescription after attempting to consult the prescriber. It is expected that the requirement to check with the prescriber in advance will not be required now that the consolidation and review of the Medicines Act 1968 and the Human Medicines Regulations are in force (PJ, 4/11 August 2012, p144).

These regulations came into force on 14 August 2012, but will all pharmacists review dosing directions and amend with confidence or should GPs be encouraged to write “as directed by the pharmacist” (especially for products like hay fever medicines, emollients, eye drops for dry eyes etc)?

Jayesh Shah



Citation: Electronicjuice URI: 11106124

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