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2017 HCHB_digital

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Medicines Safety<br />

The New Zealand Pharmacovigilance Centre (NZPhvC) is the main body in<br />

New Zealand responsible for monitoring the safety of medicines and related<br />

products in New Zealand through voluntary reporting of adverse events. The<br />

NZPhvC oversees the Centre for Adverse Reactions Monitoring (CARM), the<br />

Medication Error Reporting Programme (MERP) and the Psychoactive Substances,<br />

Recreational Substances & Legal Highs reporting programme.<br />

Adverse Reactions Monitoring<br />

CARM collects and evaluates spontaneous reports of adverse reactions to<br />

medicines, vaccines, herbal products and dietary supplements sent in by health<br />

professionals, patients and pharmaceutical companies throughout New Zealand.<br />

These reports are routinely shared with Medsafe. Over 110,000 reports are<br />

currently held by the CARM database providing New Zealand-specific information<br />

that can help contribute to knowledge already known about the adverse reaction<br />

profiles of certain medicines or complementary therapies. This knowledge can<br />

help support clinical decision making.<br />

CARM also undertakes regular analysis of the database to identify any<br />

significant patterns of adverse reactions. These results may be considered by<br />

the Medicines Adverse Reactions Committee who may suggest to Medsafe that<br />

relevant prescribing advice for a particular product be emphasised or changed.<br />

This should result in the safer use of the medicine concerned.<br />

Information collected by CARM and other international monitoring centres<br />

is fed into the World Health Organization’s International Drug Monitoring<br />

Programme database, based in Uppsala, Sweden. This allows New Zealand and<br />

other countries to keep abreast of the latest concerns around drug safety as<br />

they emerge. New Zealand is the third highest reporting country globally, behind<br />

Singapore and the United States of America.<br />

What to report<br />

It is important to report any suspect reactions of clinical concern. This includes<br />

adverse reactions or interactions to all:<br />

••<br />

medicines<br />

••<br />

vaccines<br />

••<br />

over the counter remedies or medicines<br />

••<br />

herbal, traditional and alternative remedies.<br />

Reactions and interactions that are serious and medically significant should<br />

always be reported; however, if you are unsure of its significance, report it!<br />

It is also important to report ANY serious allergic reactions so that a danger<br />

warning can be entered against the patient’s name in the national health<br />

database, so re-exposure can be avoided for that individual.<br />

How to report<br />

Anybody can report an adverse event. An online reporting form is available on the<br />

NZ Pharmacovigilance Centre website (nzphvc.otago.ac.nz). A link to this site<br />

is also available through Medsafe (www.medsafe.govt.nz/profs/adverse/<br />

reactions.asp). Alternatively, reports can be made to CARM by telephone<br />

(03 479 7247) or by downloading the ADR Reporting Card from nzphvc.<br />

otago.ac.nz/reporting-forms. Once completed, these can be either faxed<br />

(03 479 7150), emailed (nzphvc@otago.ac.nz), or posted back to:<br />

NZPhvC<br />

University of Otago Medical School<br />

PO Box 913<br />

Dunedin 9054<br />

NEW ZEALAND<br />

Medication Error Reporting Programme (MERP)<br />

MERP collects and analyses voluntary reports from healthcare professionals of<br />

actual and ‘near miss’ medication errors occurring in primary care. Its aim is to<br />

enhance the safety of medication use for New Zealanders by sharing information<br />

about medication errors to reduce and prevent other harmful medication errors.<br />

An online reporting form for MERP is available on the NZ Pharmacovigilance<br />

Centre website (nzphvc.otago.ac.nz/merp/report/).<br />

Psychoactive Substances, Recreational<br />

Substances & Legal Highs<br />

This programme aims to provide a way for health professionals and members of<br />

the public to report reactions to psychoactive substances. The programme was<br />

developed by CARM in response to a request by the Psychoactive Substances<br />

team at the Ministry of Health. Each individual report is anonymised for both<br />

patient and reporter and findings are used by the Ministry of Health as part<br />

of their ongoing safety review of products that are under review in terms of<br />

the Psychoactive Substances Act. An online reporting form is available on the<br />

NZ Pharmacovigilance Centre website (nzphvc.otago.ac.nz/substance/). The<br />

online form also links to a gallery of images of currently known psychoactive<br />

substances, which can be used to help identify the substance of concern.<br />

M 2 Medicines monitoring scheme<br />

M 2 is a medicines monitoring scheme which aims to:<br />

• • highlight safety concerns identified from reports of suspected adverse<br />

medicine reactions sent to CARM<br />

• • encourage further reports and increase the information on these potential<br />

safety concerns.<br />

This helps CARM and Medsafe to investigate these safety concerns and decide<br />

if any action needs to be taken. It is important to note that the appearance of a<br />

possible safety issue to a medicine does not mean that Medsafe and CARM have<br />

concluded that this medicine causes the reaction.<br />

Current medicines with safety concerns on the M 2 list at the time of going to<br />

print were:<br />

• • Viekira Pak and Viekira Pak-RBV – possible effects on blood glucose control<br />

when used in people with type 2 diabetes<br />

• • iodine-containing contrast agents – possible risk of hypothyroidism in infants<br />

exposed to these agents<br />

• • rivaroxaban, dabigatran, apixaban – possible risk of alopecia (hair loss).<br />

Medicines remain on the M 2 list for approximately six months and the list of<br />

medicines being monitored changes regularly. For more information see www.<br />

medsafe.govt.nz/safety/EWS/monitoring-communications.asp<br />

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