Workshop 2: Navigating the eBNF, eMC,
NetDoctor, MedicinesChest, and NHS Direct Q&As.
Use the eBNF, eMC, NetDoctor, MedicinesChest and NHSD Q&As to answer the
following questions
1
What is the starting dose
of doxazosin for
hypertension?
eBNF: Monograph for Doxazosin: Dose: Hypertension, 1
mg daily, increased after 1-2 weeks to 2mg once daily,
and thereafter to 4 mg once daily, if necessary; max. 16
mg daily
eMC: SPC for Cardura®: 4.2 Posology and method of
administration: Hypertension: Cardura is used in a once
daily regimen: the initial dose is 1mg, to minimise the
potential for postural hypotension and/or syncope.
Dosage may then be increased to 2mg after an additional
one or two weeks of therapy and thereafter, if necessary
to 4mg. The majority of patients who respond to Cardura
will do so at a dose of 4mg or less. Dosage can be
further increased if necessary to 8mg or the maximum
recommended dose of 16mg.
eMC: PIL for Cardura®:
How to take your medicine
The usual dose of Cardura is one tablet each day.
If you are taking Cardura for the first time the normal dose
is 1mg daily. After this the usual dose is 2mg or 4mg
daily. In some circumstances this may be increased to a
maximum of 8mg daily if you are being treated for
prostate enlargement, or to a maximum of 16mg if you
are being treated for high blood pressure.
NetDoctor: No information
MedicinesChest: No information
NHSD Q&As: No information
2
What active ingredient
does Flamatak MR®
contain and how much?
eBNF: [Search for Flamatak®: see under entries for
Voltarol®] Identified that Flamatak® exists as Flamatak
100 MR® and Flamatak 75 MR® containing 100mg and
75mg of diclofenac sodium respectively.
eMC: No information
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
NetDoctor: Monograph for Flamatak MR®: Identified as
Diclofenac sodium but no strength
MedicinesChest: No information
NHSD Q&As: No information
3
Can I buy Almogran® in
the chemist?
eBNF: Entry for Almogran®: POM (prescription only
medicine)
eMC: SPC for Almogran® 12.5 tablets: 11. Legal
category: POM (prescription only medicine)
eMC: PIL for Almogran® 12.5 tablets: No Information
NetDoctor: Monograph for Almogran®: Prescription only
(POM - prescription only medicine)
MedicinesChest: No information
NHSD Q&As: No information
4
Name three side effects
of Distamine®.
eBNF: Monograph for Penicillamine: Side effects: Many
noted including initially nausea, anorexia, fever, and skin
reactions.
eMC: SPC for Distamine® 125mg film-coated tablets: 4.8
Undesirable effects: Nausea, anorexia, fever and rash
may occur early in therapy.
eMC: PIL Distamine® 125mg Distamine tablets
sometimes cause the following side effects in some
people. Increasing the dose very slowly will help to
control these side effects.
When you start taking the tablets you may feel sick or
even be sick. You may lose your appetite or notice that
food tastes different. These side effects usually wear off,
but tell your doctor if they trouble you.
NetDoctor: Monograph for Distamine®: Side effects list
includes nausea, decreased appetite, fever (pyrexia), skin
rashes.
MedicinesChest: No information
NHSD Q&As: No information
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
5
What ingredients does
Asilone® antacid liquid
contain, and how much?
eBNF: Entry for Asilone®: Suspension , sugar-free, dried
aluminium hydroxide 420 mg, simeticone 135 mg, light
magnesium oxide 70 mg/5 mL (low Na+)
eMC: No information
NetDoctor: Entry for Asilone® antacid liquid: Aluminium
hydroxide, activated dimeticone, light magnesium oxide.
No information on amounts.
MedicinesChest: Entry for Asilone® antacid liquid:
Spearmint flavoured sugar-free suspension containing in
5ml: Aluminium hydroxide 420 mg, Dimethicone activated
(Simethicone) 135 mg, Light magnesium oxide 70 mg
NHSD Q&As: No information
6
Can phenelzine and
pseudoephedrine be
taken together safely?
eBNF: Interaction search – tree structure demonstrates
phenelzine is an MAOI: MAOIs and pseudoephedrine –
potentially hazardous; risk of hypertensive crisis when
MAOIs given with pseudoephedrine.
eMC: SPC for Non-drowsy Sudafed Decongestant
Tablets® which contain Pseudoephedrine Hydrochloride
60.00 mg: 4.5 Interaction with other medicinal products
and other forms of interaction: Concomitant use of NonDrowsy Sudafed Decongestant Tablets with tricyclic
antidepressants, sympathomimetic agents (such as
decongestants, appetite suppressants and amfetaminelike psychostimulants) or with monoamine oxidase
inhibitors, which interferes with the catabolism of
sympathomimetic amines, may occasionally cause a rise
in blood pressure.
eMC: PIL No PILs available
NetDoctor: Monograph for Sudafed 12 hour relief®: How
can this medicine affect other medicines? You should not
take this medicine if you are currently taking a
monoamine oxidase inhibitor (MAOI) antidepressant (eg
phenelzine, isocarboxazid, tranylcypromine or
moclobemide), or if you have taken one of these
medicines in the last 14 days. This is because the
combination could cause a dangerous rise in blood
pressure.
MedicinesChest: No information
NHSD Q&As: No information
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
7
When can I drink alcohol
again after taking a
course of
metronidazole?
eBNF: No information.
eMC: SPC for Flagyl® tablets 200mg, 400mg: 4.5
Interaction with other medicinal products and other forms
of interaction: Patients should be advised not to take
alcohol during metronidazole therapy and for at least 48
hours afterwards because of the possibility of a
disulfiram-like (antabuse effect) reaction.
eMC: PIL for Flagyl® S Suspension
You are advised not to drink any alcohol whilst taking
Flagyl® S suspension, and for 48 hours after finishing
your course of the suspension, as this might cause
unpleasant side-effects, such as nausea and vomiting,
abdominal pain, hot flushes, palpitations, and headache.
NetDoctor: Entry for Flagyl® tablets (Metronidazole):
Warning: You should not drink alcohol while taking this
antibiotic, and for at least 48 hours after finishing the
course, as this can cause unpleasant symptoms such as
hot flushes, abdominal cramps, nausea, vomiting,
headache and palpitations.
MedicinesChest: No information
NHSD Q&As: UKMi Q&A N14.2: When can patients start
drinking alcohol after finishing metronidazole? Fully
referenced answer.
8
Can ibuprofen and
lithium be taken together
safely?
eBNF: Interaction search for ibuprofen and lithium –
potentially hazardous; ibuprofen reduces excretion of
lithium (increased risk of toxicity).
eMC: SPC for Camcolit 250 tablets®: 4.5 Interaction with
other medicinal products and other forms of interaction
Serum lithium concentrations may increase during
concomitant therapy with non-steroidal anti-inflammatory
drugs, or tetracycline, possibly resulting in lithium toxicity.
Serum lithium concentrations therefore should be
monitored more frequently if NSAID or tetracycline
therapy is initiated or discontinued.
eMC: PIL for Camcolit 250 tablets®:
Consult your doctor before taking Camcolit if you are
taking any of the following medications:
 diuretics (water tablets)
 anti-depressants called tricyclics or tetracyclics
antibiotics called tetracyclines
 non-steroidal anti-inflammatory drugs. These
are used for rheumatism and for other pains. You
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1





can also get pain killers of this type without a
prescription, so check with your pharmacist before
you buy them. Aspirin and paracetamol do not
react with lithium.
for heart rhythm disorders (quinidine, lidocaine,
flecainide, amiodarone, sotalol)
for the treatment of leukaemia (arsenic trioxide)
for the treatment of nausea and vomiting
(dolasetron)
for the treatment of an infection given into a vein
(erythromycin)
for the treatment of malaria (mefloquine)
NetDoctor: Monograph for Camcolit®: How can this
medicine affect other medicines? The following medicines
may increase the level of lithium in the blood, causing an
increased risk of lithium side effects or toxicity: List
includes - non-steroidal anti-inflammatory drugs
(NSAIDs), such as indomethacin, diclofenac, ibuprofen,
celecoxib.
MedicinesChest: No information
NHSD Q&As: No information
9
Can azithromycin be
used in a patient with
liver disease?
eBNF: Monograph for azithromycin: Contraindications:
Hepatic impairment.
eMC: SPC for Zithromax® capsules, suspension®: 4.2
Posology and method of administration Hepatic failure:
Since azithromycin is metabolised in the liver and
excreted in the bile, the drug should not be given to
patients suffering from severe liver disease. No studies
have been conducted regarding treatment of such
patients with azithromycin.
eMC: PIL for Zithromax® capsules
Before you take your medicine
If the answer to any of the questions below is YES do not
take Zithromax®. Go back and see your doctor.
Have you ever had an allergic reaction, skin rash or
wheezing after taking Zithromax® or any other macrolide
antibiotic such as erythromycin?
Do you have liver problems?
Are you taking any ergot derivatives such as ergotamine
(used to treat migraine)?
NetDoctor: Monograph for Zithromax®: Not to be used in
Liver disease.
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
MedicinesChest: No information
NHSD Q&As: No information
10
I am taking simvastatin
10mg, one tablet every
day for my high
cholesterol – does it
matter what time I take
it?
eBNF: Monograph for simvastatin: Dose: primary
hypercholesterolaemia, combined hyperlipidaemia, 10–20
mg daily at night, adjusted at intervals of at least 4 weeks;
usual range 10–80 mg once daily at night
eMC: SPC for Zocor® 10mg, 20mg, 40mg and 80mg filmcoated tablets: 4.2 Posology and method of
administration: The dosage range is 5 - 80 mg/day given
orally as a single dose in the evening.
eMC: PIL for Zocor® 10mg, 20mg, 40mg and 80mg filmcoated tablets:
You should take your tablets exactly as advised by your
doctor or pharmacist. The usual starting dose is 20 or 40
mg a day, given as a single dose in the evening. It is
recommended that Zocor® is taken in the evening, or at
night, so that it will be working when the body is
producing the most cholesterol. Your doctor may adjust
your dose to a maximum of 80 mg per day, given as a
single dose in the evening.
NetDoctor: Monograph for simvastatin: How does it
work? As the body produces most cholesterol at night,
statins are generally more effective if taken at night.
MedicinesChest: No information
NHSD Q&As: No information
11
What is the dose of
Cystopurin® for cystitis?
eBNF: No information
eMC: No information
NetDoctor: Entry for Cystopurin®: How does it work?
The contents of one Cystopurin® sachet should be taken,
dissolved in a glass of water, three times a day for two
days. You should also try and drink as much water as you
can during the treatment, to help flush any bacteria out of
your bladder. Note – NetDoctor does not usually
contain dosage information.
MedicinesChest: Entry for Cystopurin®: Dosage: Adults,
elderly and children over 6 years: 1 sachet dissolved in
200ml cold water taken 3 times daily for 2 days. Not
recommended under 6 years.
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
NHSD Q&As: No information.
12
Can paracetamol be
taken with amoxicillin?
eBNF: No information
eMC: No information
NetDoctor: No information
MedicinesChest: No information
NHSD Q&As: UKMi Q&A N4.2: Does paracetamol
interact with antibiotics? Fully referenced answer.
13
Do Seroquel® 300 tablets eBNF: No information
have lactose in them?
eMC: SPC for Seroquel®: 6.1 List of excipients: Lactose
monohydrate is listed as an excipient in the tablet core.
eMC: PIL for Seroquel®: Your medicine is called
Seroquel. Its active ingredient is quetiapine. Seroquel®
tablets have either 25 milligrams (mg), 100 mg, 150 mg,
200 mg or 300 mg quetiapine in them. Each tablet also
contains several inactive ingredients which allow it to be
made. These are: calcium hydrogen phosphate,
hypromellose, lactose, magnesium stearate,
microcrystalline cellulose, polyethylene glycol, povidone,
sodium starch glycollate and titanium dioxide. The 25 mg,
100 mg and 150 mg tablets also contain ferric oxide.
NetDoctor: No information
MedicinesChest: No information
NHSD Q&As: No information
14
After opening a bottle of
Reminyl® solution, how
long does it last?
eBNF: No information
eMC: SPC for Reminyl® Oral solution: 6.3 Shelf life: 2
years. After first opening: 3 months.
eMC: PIL for Reminyl® Oral solution
Medicines can be kept for a limited period only.
Therefore, do not use Reminyl after the expiry date
printed on the packaging. Reminyl oral solution should not
be used for longer than 3 months after the bottle has first
been opened.
NetDoctor: No information
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1
MedicinesChest: No information
NHSD Q&As: No information
15
Does food affect the
absorption of
levofloxacin?
eBNF: No information.
eMC: SPC for Tavanic® 250mg tablets: 4.2 Posology and
method of administration: The tablets may be taken
during meals or between meals.
eMC: PIL for Tavanic® 250mg, 500mg tablets
The tablets may be taken during meals or at any time
between meals.
NetDoctor: No information
MedicinesChest: No information
NHSD Q&As: No information
16
I’ve just started on
methotrexate tablets.
Can I still drive?
eBNF: Monograph for methotrexate: Side effects:
Drowsiness is listed.
eMC: SPC for Maxtrex® 2.5mg tablets: 4.7 Effects on
ability to drive and use machines: None known.
eMC: PIL for Maxtrex® 2.5mg
No Information
NetDoctor: Monograph for Maxtrex®: Side effects:
Drowsiness is listed.
MedicinesChest: No information
NHSD Q&As: No information
Role Preparation for Nurse Advisors: Handling Medicines Calls
May 2008 V1.1