1. High Risk Medicines

  • The medicines are associated with preventable harm caused by omission, overuse or incorrect use
  • The harm could be prevented by an MUR and the pharmacist has the skills, knowledge and information to deliver it
  • The focus is on medicines where an MUR could improve patient safety
  • The purpose of an MUR is to address problems with medicines use rather than dosage

BNF 4.2.3 Antimanic drugs

  • Lithium carbonate (Camcolit, Liskonum, Priadel
  • Lithium citrate (Li-Liquid, Priadel liquid)

BNF 10.1.3 Drugs that suppress the rheumatic disease process

  • Methotrexate (Maxtrex, Ebetrex, Metoject)

BNF 10.1.1 NSAIDs

  • Aceclofenac (Preservex)
  • Acemetacin (Emflex)
  • Celecoxib (Celebrex)
  • Dexibuprofen (Seractil)
  • Dexketoprofen (Keral)
  • Diclofenac potassium (Voltarol Rapid)
  • Diclofenac sodium (Voltarol, Diclomax)
  • Diclofenac sodium with misoprostol (Arthrotec)
  • Etodolac (Lodine SR)
  • Etoricoxib (Arcoxia)
  • Fenbufen
  • Fenoprofen (Fenopron)
  • Flurbiprofen (Froben)
  • Ibuprofen (Brufen)
  • Indometacin
  • Ketoprofen (Oruvail)
  • Ketoprofen with omeprazole (Axorid)
  • Mefenamic acid (Ponstan)
  • Meloxicam (Mobic)
  • Nabumetone (Relifex)
    Naproxen (Naprosyn, Synflex)
  • Naproxen with esomeprazole (Vimovo)
  • Naproxen with misoprostol (Napratec)
  • Piroxicam (Feldene)
  • Sulindac 
  • Tenoxicam (Mobiflex)

  • Tiaprofenic acid (Surgam)

BNF 2.8.2 Oral anticoagulants

  • Warfarin sodium
  • Acenocoumarol (Sinthrome)
  • Phenindione
  • Dabigatran etexilate (Pradaxa)

  • Rivaroxaban (Xarelto)

BNF 2.9 Antiplatelet drugs

  • Abciximab - Specialist use only
  • Aspirin 75mg (Caprin, Nu-Seals)
  • Clopidogrel (Plavix)
  • Dipyridamole (Persantin)
  • Dipyridamole with aspirin (Asasantin)
  • Eptifibatide - Specialist use only
  • Prasugrel (Efient)
  • Tirofiban - Specialist use only

BNF 2.2.1 Thiazides and related diuretics

  • Bendroflumethiazide - Dual use: oedema, mild-moderate heart failure
  • Chlortalidone (Hygroton) - Dual use: ascites, oedema, heart failure, diabetes insipidus
  • Cyclopenthiazide (Navidrex) - Dual use: oedema, heart failure
  • Indapamide (Natrilix)
  • Metolazone (Metenix) - Dual use: oedema
  • Xipamide (Diurexan) - Dual use: oedema

BNF 2.2.2 Loop diuretics

  • Furosemide
  • Bumetanide (Burinex)
  • Torasemide (Torem)

BNF 2.2.3 Potassium-sparing and aldosterone antagonists

  • Amiloride
  • Triamterene (Dytac)
  • Eplerenone (Inspra)
  • Spironolactone (Aldactone)

BNF 2.2.4 Potassium sparing combinations

  • Co-amilozide (Navispare)
  • Co-amilofruse (Frumil)
  • Amiloride with bumetanide
  • Co-triamterzide (Dyazide)
  • Triamterene with chlortalidone (Kalspare)
  • Triamterene with furosemide (Frusene)
  • Co-flumactone (hydroflumethiazide with spironolactone)
  • Spironolactone with furosemide (Lasilactone)

BNF 2.2.5 Osmotic diuretics

  • Mannitol

BNF 2.2.8 Diuretics with potassium

  • Furosemide with potassium (Diumide-K Continus)

  • Bendroflumethiazide with potassium (Neo-NaClex-K)

2. Patients with Respiratory Disease (Asthma and COPD)

BNF 3.1.1 Adrenoceptor agonists

  • Bambuterol hydrochloride (Bambec)
  • Fenoterol hydrobromide (Duovent)
  • Formoterol fumarate (Atimos, Foradil Oxis)
  • Indacaterol (Onbrez Breezhaler)
  • Salbutamol (Airomir, Asmasal, Salamol, Ventolin)
  • Salmeterol (Serevent)
  • Terbutaline sulphate (Bricanyl)

BNF 3.1.2 Antimuscarinic bronchodilators

  • Ipratropium bromide (Atrovent)
  • Tiotropium (Spiriva)

BNF 3.1.3 Theophylline

  • Theophylline (Nuelin SA, Slo-phyllin, Uniphyllin)
  • Aminophylline (Phyllocontin)

BNF 3.1.4 Compound bronchodilator preparations

  • Ipratropium bromide with salbutamol (Combivent)
  • Fenoterol hydrobromide with ipratropium bromide (Duovent)

BNF 3.2 Corticosteroids

  • Beclometasone (Clenil, Qvar)
  • Beclometasone with formoterol (Fostair)
  • Budesonide (Pulmicort)
  • Budesonide with formoterol (Symbicort)
  • Ciclesonide (Alvesco)
  • Fluticasone proprionate (Flixotide)
  • Fluticasone with salmeterol (Seretide)
  • Mometasone furoate (Asmanex)

BNF 3.3.1 Cromoglicate and related therapy

  • Sodium cromoglicate (Intal) - Dual use: food allergies, allergic conjunctivitis, allergic rhinitis
  • Nedocromil (Tilade)

BNF 3.3.2 Leukotriene receptor antagonists

  • Montelukast (Singulair) - Dual use: seasonal allergic rhinitis in patients with asthma
  • Zafirlukast (Accolate)

BNF 3.3.3 Phosphodiesterase type-4 inhibitors

  • Roflumilast (Daxas)


3. Patients with Hypertension prescribed an Antihypertensive

BNF 2.2.1 Thiazides and related diuretics

  • Bendroflumethiazide - Dual use: oedema, mild-moderate heart failure
  • Chlortalidone (Hygroton) - Dual use: ascites, oedema, heart failure, diabetes insipidus
  • Cyclopenthiazide (Navidrex) - Dual use: oedema, heart failure
  • Indapamide (Natrilix)
  • Metolazone (Metenix) - Dual use: oedema
  • Xipamide (Diurexan) - Dual use: oedema

BNF 2.4 Beta-adrenoceptor blocking drugs

  • Propranolol hydrochloride
  • Acebutolol (Sectral)
  • Atenolol
  • Atenolol with chlortalidone (co-tenidone, Tenoretic)
  • Atenolol with amiloride and hydrochlorothiazide (Kalten)
  • Atenolol with nifedipine (Beta-Adalat, Tenif)
  • Bisoprolol (Cardicor, Emcor)
  • Carvedilol (Eucardic)
  • Celiprolol (Celectol)
  • Labetalol (Trandate)
  • Metoprolol (Betaloc, Lopresor)
  • Nadolol (Corgard)
  • Nebivolol (Nebilet, Hypoloc)
  • Oxprenolol (Trasicor)
  • Oxprenolol with cyclopenthiazide (Trasidrex)
  • Pindolol (Visken)
  • Pindolol with clopamide (Viskaldix)
  • Sotalol (Beta-Cardone, Sotacor)
  • Timolol (Betim)
  • Timolol with amiloride and hydrochlorothiazide (Non-proprietary)
  • Timolol with bendroflumethiazide (Prestim)

BNF 2.5.2 Centrally acting antihypertensive drugs

  • Clonidine (Catapres)
  • Methyldopa (Aldomet)
  • Moxonidine (Physiotens)

BNF 2.5.4 Alpha-adrenoceptor blocking drugs

  • Doxazosin (Cardura)
  • Indoramin (Doralese)
  • Prazosin (Hypovase)
  • Terazosin (Hytrin)

BNF 2.5.5.1 Angiotensin-converting enzyme inhibitors (ACE inhibitors)

  • Captopril (Capoten)
  • Captopril with hydrochlorothiazide (Co-zidocapt, Capozide)
  • Cilazapril (Vascace)
  • Enalapril (Innovace)
  • Enalapril with hydrochlorothiazide (Innozide)
  • Fosinopril
  • Imidapril (Tanatril)
  • Lisinopril (Zestril)
  • Lisinopril with hydrochlorothiazide (Carace Plus, Zestoretic)
  • Moexipril (Perdix)
  • Perindopril erbumine (= tertiary butylamine)
  • Perindopril arginine (Coversyl Arginine)
  • Perindopril arginine with indapamide (Coversyl Arginine Plus)
  • Quinapril (Accupro)
  • Quinapril with hydrochlorothiazide (Accuretic)
  • Ramipril (Tritace)
  • Ramipril with felodipine (Triapin)
  • Trandolapril (Gopten)
  • Trandolapril with verapamil (Tarka)

BNF 2.5.5.2 Angiotensin-II receptor antagonists

  • Candesartan cilexetil (Amias)
  • Eprosartan (Teveten)
  • Irbesartan (Aprovel)
  • Irbesartan with hydrochlorothiazide (Co-Aprovel)
  • Losartan potassium (Cozaar)
  • Losartan with hydrochlorothiazide (Cozaar-Comp)
  • Olmesartan medoxomil (Olmetec)
  • Olmesartan with amlodipine (Sevikar)
  • Olmesartan with hydrochlorothiazide (Olmetec Plus)
  • Telmisartan (Micardis)
  • Telmisartan with hydrochlorothiazide (Micardis Plus)
  • Valsartan (Diovan)
  • Valsartan with hydrochlorothiazide (Co-Diovan)

BNF 2.5.5.3 Renin inhibitors

  • Aliskiren (Rasilez)


BNF 2.6.2 Calcium-channel blockers

  • Amlodipine (Istin)
  • Amlodipine with valsartan (Exforge)
  • Diltiazem (Tildiem, Adizem, Angitil, Dilzem)
  • Felodipine (Plendil)
  • Isradipine (Prescal)
  • Lacidipine (Motens)
  • Lercanidipine (Zanidip)
  • Nicardipine (Cardene)
    Nifedipine (Adalat, Adipine, Coracten, Nifedipress)
  • Nimodipine (Nimotop)
  • Verapamil (Cordilox, Securon, Univer)

4. Patients Prescribed a Medicine no longer Required

a) Repeat prescriptions are not synchronised - patient presents on multiple occasions each month to collect prescriptions.

b) ‘When required' PRN medicines are ordered routinely - patient routinely orders medicines prescribed ‘prn' which would normally be taken only when required

c) Medicines waste is returned to the pharmacy - patient returns unused medicines for disposal