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NICE backs daily pill for alcohol dependence in draft guidance

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Patients with alcohol dependence problems should be offered a once-a-day tablet on the NHS to try to help them curb their addiction, health officials have said.

The drug nalmefene (Selincro) should be made available to heavy drinkers, the National Institute of Health and Care Excellence (NICE) said today in new draft guidance.

Around 600,000 people across England and Wales could benefit from the drug in their struggle with alcohol dependence, its manufacturers Lundbeck have estimated.

The drug helps to reduce the craving for alcohol by modulating the reward mechanism in the brain.

The draft guidance from NICE states that nalmefene should be available as an option for those who are heavy drinkers but not those who require immediate detoxification.

“Alcohol addiction is a serious issue for so many,” said Professor Carole Longson, director of NICE’s Health Technology Evaluation Centre.

Professor Carole Longson

Carole Longson

“Those who could be prescribed nalmefene have already taken the first big steps in their fight against their addiction by visiting their doctor and taking part in therapy programmes,” she said.

“We are pleased to be able to make draft recommendations which can support people in their fight,” she added.

“When used alongside psychosocial interventions, nalmefene is clinically and cost effective for the NHS compared with psychosocial interventions alone.”

A consultation has been opened on the draft guidance and it is expected final guidance will be published in November.

Nalmefene is an opioid receptor modulator, which exhibits antagonist activity at the mu and delta opioid receptors, and partial agonist activity at the kappa opioid receptors.

It is administered orally as 18 mg film-coated tablets and the maximum dose is one tablet daily. It is priced at £42.42 for a pack of 14 tablets or £84.84 for a packet of 28 tablets.

Under its license, nalmefene should only be started in patients who continue to have a high drinking risk level two weeks after initial assessment and should only be prescribed in conjunction with continuous psychosocial support.

Nausea, dizziness, insomnia and headaches are listed in product summary information as possible adverse reactions from the drug.


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