Regulatory updates

Levemir insulin — discontinued

Novo Nordisk has announced that all formulations of Levemir insulin will be discontinued by the end of 2026.The HSE Pharmacist Communication and Patient Information Leaflet can be downloaded from ipu.ie/ipu-document/levemir-discontinuation. It is advised that you highlight this important update to the relevant patients.

 

Risk of serious eye complications with Semaglutide (Ozempic, Wegovy)

• Diabetic retinopathy

In patients with diabetic retinopathy treated with insulin and semaglutide, an increased risk of developing diabetic retinopathy complications has been observed. The SPC states that caution should be exercised when using semaglutide in patients with diabetic retinopathy treated with insulin. These patients should be monitored closely.

The SPC also states that there is no experience with semaglutide in patients with Type 2 Diabetes with uncontrolled or potentially unstable diabetic retinopathy and semaglutide is therefore not recommended in these patients.

These are key counselling points for patients with diabetes who are taking semaglutide.

Additionally, patients with diabetes should be reminded to register for the Diabetic Retina Screen programme. This is available free of charge to all patients with Type 1 and Type 2 Diabetes. Further information can be found at www2.hse.ie > Health A to Z > Diabetic retinopathy > Diabetic RetinaScreen.

• Risk of non-arteritic ischemic optic neuropathy

The HPRA Drug Safety Newsletter, December 2025, gave an update on the risk of non-arteritic ischemic optic neuropathy (NAION) occurring with semaglutide. NAION is a serious ocular condition that compromises the blood supply to the optic nerve, potentially leading to sudden unilateral vision loss. After evaluating all available data, the Pharmacovigilance Risk Assessment Committee (PRAC) concluded that NAION is a very rare adverse effect of semaglutide.

Advice for pharmacists:

• If patients experience a sudden loss of vision or rapidly worsening eyesight during treatment with semaglutide, they should contact their doctor without delay; and
• A sudden loss of vision should lead to ophthalmological examination.

 

Controlled drugs storage

Pharmacy owners and those in governance role must ensure that controlled drug medicines (CDs) listed either in Schedule 2 (CD2) or 3 (CD3) of the Misuse of Drugs Regulations 2017 (as amended) are stored in a cabinet which is secured to a concrete wall or floor and meets the requirements outlined in the Misuse of Drugs (Safe Custody) Regulations, 1982 (S.I. No. 321 of 1982) (as amended).

This storage condition will apply not only to CD2 and CD3 medicines procured by the pharmacy, but also to patient-returned CDs awaiting destruction. Please remember that any non-conforming CDs (including expired CDs and patients’ CD returns) must be segregated from ‘live’ stock and clearly labelled ‘CDs for destruction’ while waiting for destruction.

PSI Guidelines on the Storage of Medicinal Products within a Retail Pharmacy Business and PSI Advice on Controlled Drug Compliance provide clear guidance on how to comply with these legal requirements. This information is available at psi.ie.

 

IPU practice support

The IPU- Professional Services webpage has been updated to include information about the HSE National Condom Distribution Service (NCDS). This service aims to distribute free condoms and lubricant sachets to services working directly with population groups who may be at increased risk of negative sexual health outcomes. The HSE will be contacting those community pharmacies who signed up to the 2025 Community Pharmacy Agreement within the coming months. Pharmacies will be offered the opportunity to opt in and support their communities in their sexual wellbeing.

More information about the implementation of this service is available at ipu.ie > Professional > National Condom Distribution Service.

 

Useful reference source

New warfarin and DOAC Booklets developed by HSE

New patient education materials have been developed by the national VTE Patient Information Group to support safe and informed use of oral anticoagulants by patients.

These are the first national, patient education booklets in Ireland on Warfarin and DOACs, co-designed by iterative cycles of expert panel and patient consensus.

They have been implemented at national level and are freely accessible for patients and clinical staff. The booklets are intended to provide essential information to patients, reduce variation in practice and reduce preventable harm. They are also intended to assist clinicians by providing standardised, credible, educational materials that can be implemented consistently across healthcare settings. The materials are designed to be adaptable for use by local, regional, national, and international patient safety and education initiatives. These resources are available to order via healthpromotion.ie  

The Spring webinar programme from IPU Professional Academy also covers VTE Awareness, Assessment, Prevention and Management, along with this month’s article on warfarin.

 

Professional guidance

First aid kit for pets

Pharmacies offer first aid kits to the public, providing support for managing minor ailments at home that require urgent care. Similarly, pharmacies may also offer first aid kits for pets. Animal owners may find themselves in situations where their pet has been injured or is at risk of losing its life. On those occasions, the first step before attending a veterinary practice is to reach out to the first aid for pets. An infographic on Common Pet Emergencies First Aid Kit is available from MSD Manual (Veterinary Manual), at msdvetmanual.com > Resources > Infographics. This resource provides advice on the stock that should be included in this kit and warnings regarding the usage of some of the items.