Nalmefene

Nalmefene (trade name Selincro) is a drug which is used primarily in the management of alcohol dependence. The drug is licensed by Lundbeck and was approved by the Scottish Medicines Consortium (SMC) on 7 October 2013, making Scotland the first country in Europe to prescribe the new drug.

The SMC advice states:

nalmefene 18mg film-coated tablets (Selincro®) are accepted for use within NHS Scotland.

Indication under review: the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking risk level (DRL), without physical withdrawal symptoms and who do not require immediate detoxification. Nalmefene should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption. Nalmefene should be initiated only in patients who continue to have a high DRL two weeks after initial assessment.

In a post hoc analysis of two pivotal phase III studies representing the licensed population, nalmefene was shown to significantly reduce alcohol intake compared with placebo, measured as a reduction in heavy drinking days and total alcohol consumption over a six month period.

In response to the news of Nalmefene's approval for use in Scotland, Professor Jonathan Chick, a consultant psychiatrist at Queen Margaret University Hospital Edinburgh, said: 'I am pleased that Scottish patients will have access to nalmefene, which represents a new option for treating some people with alcohol dependence by helping them to cut down their drinking when they may not be ready, or have no medical need, to give up alcohol altogether. This may help us to engage the many alcohol-dependent patients that we know are not currently receiving help.'

Side Effects

• Common: drowsiness, hypertension, tachycardia, dizziness, nausea, vomiting
• Occasional: fever, hypotension, vasodilatation, chills, headache
• Rare: agitation, arrhythmia, bradycardia, confusion, hallucinations, myoclonus, itching