Medicines and Foods: Interaction (Hansard, 31 March 2004)

§ Baroness Andrews
My Lords, all medicines must be accompanied by a patient information leaflet, which sets out any recorded interactions between the medicine prescribed and other medicines or foods. The Government are continuing vigorously to encourage manufacturers to provide clear and accessible information about their products to enable them to be used safely and correctly. In addition, a range of advice will be given to patients at the time of prescribing and dispensing.

§ Baroness Masham of Ilton
My Lords, I thank the noble Baroness, Lady Andrews, for her Answer and give special thanks for her hard work. I declare a personal interest as my husband has had exceedingly complex and difficult problems. He is on warfarin, and his INR blood coagulation has gone over 10 twice. It is today very dangerous indeed. Is the noble Baroness aware that he was on antibiotics, which can result in problems, and also on grapefruit juice?

§ Baroness Andrews
My Lords. I am sure that everyone will want to send their best wishes to the noble Baroness's husband for a speedy recovery.
Warfarin is a powerful anti-coagulant; there are some known interactions with certain antibiotics. There is also a potential reaction with cranberry juice, which has come to light very recently, and doctors have been informed about it. But I can assure the noble Baroness that the patient information leaflet, which should be provided with every medicine prescribed, should give all information about known interactions, so the doctor involved should also be able to give that information.

§ Lord Clement-Jones
My Lords, does the Minister agree that the interaction of medicines and the administration of medication is particularly important in care homes? I am sure she will have noted the National Care Standards Commission's report,
1315 The Management of Medication in Care Services, which shows that out of 16,500 care homes, some 2,500, for children and for older people, are failing to meet those standards. What is the Government's response to that report?

§ Baroness Andrews
My Lords, the noble Lord has drawn attention to a very important issue. We are very concerned that the National Care Standards Commission's report showed that so many care homes did not meet the standard. However, we were encouraged by the fact that the figures for this year are an improvement on last year. There is clearly room for improvement. We will be looking carefully at the recommendations and following them up as soon as possible, wherever possible.

§ Earl Howe
My Lords, will the Minister undertake to look at this issue as it affects mothers who are breastfeeding? Pharmaceutical companies are not currently required to provide information about the safety of drugs in lactation. The majority of newly developed medicines are labelled "not to be taken by breastfeeding women", not because they are necessarily unsafe but because there are no data to support such approvals. Will the Government encourage the pharmaceutical industry to collect data from GPs on this very important issue?

§ Baroness Andrews
Yes, my Lords, it is important. My advice is that information on whether a drug passes into breast milk is included in the summary of product characteristics and the patient information leaflet, when it is known. Of course, the BNF—the British National Formulary—also contains detailed information on medicines that will be present in breast milk if the mother is treated. I undertake to write to the noble Earl with any other information that I have on the specific issues that he raised.

§ Baroness Goudie
My Lords, does the Minister agree that should there be not only a list of potential foods that are dangerous when taking drugs but information about combining alcohol and drugs? In many cases, that can cause very bad side-effects, and in some cases it can be fatal.

§ Baroness Andrews
Yes, my Lords, the noble Baroness is absolutely right. Alcohol is a very powerful drug in itself and, when there is a known interaction with a particular medicine, that information should certainly be in the information leaflet. I remind noble Lords that the patient information leaflet is required by law to be provided with every medicine prescribed.

§ Baroness Gardner of Parkes
My Lords, we have had all the negative side of the question—and, of course, it is a very important matter. However, the effect of some 1316 drugs is enhanced by combining them with other drugs. We have all read, I am sure, about a marvellous pill that we shall be able to take: six different tablets a day will keep us alive for long enough to see this place out! When will we receive information about that magic pill, which has been talked about so widely?

§ Baroness Andrews
My Lords, I have very extensive briefing, but I have absolutely nothing on this magic pill. I doubt very much that I shall live long enough, with the stress of this particular role, to see it. But I shall see what I can do and provide some further information.

§ Baroness Hayman
My Lords, on the issue of the dearth of data referred to by the noble Earl, Lord Howe, does my noble friend agree that it is a particular problem in relation to paediatric prescribing, and therefore the information that can be given in that regard? There has been a lack of non-therapeutic clinical trials for children, for understandable reasons, but has any progress been made on getting better information on prescribing for children?

§ Baroness Andrews
My Lords, prescribing medicines for children has been constrained traditionally by ethical considerations. It has been a concern that we have not sometimes been able to provide appropriate medicines for children because of that. However, the UK is supporting a European proposal to set out a framework for requirements and incentives for research and development into appropriate medicines. That is a very important step forward. We expect to take a leading role in that.
We are also developing our own national strategy. We want to encourage more paediatric research_. I am sure that the noble Baroness will be as pleased as I was to see that one of the five areas that has been prioritised for additional funding for medical research in the next few years will be paediatric medicine. We aim to bring together the paediatric research centres to ensure faster progress. That, plus the national service framework for children, is very good news.

§ Baroness Sharples
My Lords, can the Minister assure us that the information will be written in extremely simple language?

§ Baroness Andrews
Yes, my Lords. The labelling of medicines is absolutely crucial. By law, labels are supposed to be understandable and readable. That should apply for everyone. We have had a report from the Committee on Safety of Medicines, which considered ways in which to provide clearer information, by colour-coding packages to distinguish between medicines, and so on. We are very alert to the issue and to involving patients more in the management of their own medicines. For that, they really do need a lot of information.