Published: 6 June 2024


MARC’s remarks: March 2024 meeting

Published: 6 June 2024
Prescriber Update 45(2): 33–34
June 2024

The Medicines Adverse Reaction Committee (MARC) convened for their 197th meeting on 14 March 2024.

The Committee discussed the risk of renal tubular acidosis (RTA) and severe hypokalaemia with ibuprofen. They noted that hypokalaemic RTA appears to be specific to ibuprofen rather than a class effect of non-steroidal anti-inflammatory medicines (NSAIDs). The Committee agreed that the risk of hypokalaemic RTA with ibuprofen is dose dependent. The Committee recommended updates to the ibuprofen data sheets to state that the risk is increased with higher doses of ibuprofen and following acute overdose, however, it may also occur within the recommended dose range. The Committee also recommended that the data sheets include signs and symptoms of RTA to prompt healthcare professionals to consider this diagnosis in patients with unexplained hypokalaemia.

The Committee reviewed information on co-ingestion of serotonin and noradrenaline re-uptake inhibitors (SNRIs)/selective serotonin re-uptake inhibitors (SSRIs) with alcohol in overdose and suicide. The Committee discussed the synergistic pharmacodynamic mechanism between alcohol and medicines that cause CNS depression and stated that this combination is not advisable. They agreed that venlafaxine toxicity is different to that of SSRIs due to venlafaxine’s potential for cardiac complications or seizures.

The Committee recommended that all SSRI data sheets contain consistent information about use with alcohol. The Committee noted that the venlafaxine data sheet was recently updated regarding this topic, so no further updates were required.

See the Medsafe website for the MARC meeting minutes and the reports presented to the MARC.

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