Safety in prescribing

Welcome to this February issue of the Journal of Prescribing Practice.

One thing all prescribers strive for is safety in prescribing practice. As an educator, I am always on the lookout for safety warnings or updated advice on prescribing certain medications or in certain conditions.

The drug valproate has been on the safety in prescribing radar for quite a while, with a change to regulatory measures meaning that no woman or girl of childbearing age can be prescribed it unless there is a pregnancy prevention programme in place, or there is no other effective treatment available.

In November 2023, the MHRA instructed health organisations to plan for new measures to reduce ongoing serious harm from sodium valproate, which came into effect on 31 January 2024 (MHRA, 2023). The MHRA statement means that, from January 2024, valproate must not be started in new patients (male or female) younger than 55 years, unless two specialists independently consider and document that there is no other effective or tolerated treatment, or there are compelling reasons that the reproductive risks do not apply. For most patients, other effective treatment options are available.