How to order a repeat prescription
Your GP will prescribe most of your usual medications and some of your rheumatology medications. Please follow these steps to request a repeat prescription if we have asked you to do that.
- Ring prescription line (0191 213 7967) or email [email protected]
- Please then leave a message on the answerphone clearly telling us:
- Your name
- Your hospital (MRN) number/NHS number
- The name of the medication you need
- The dose of the medication you need
- When you would like to collect you medication (at least 7 working days later)
- If your medication is one of those listed below the prescription will now be issued to your local community pharmacy (the same pharmacy that you use to collect prescriptions issued by your GP for you to collect).
- Methotrexate
- Hydroxychloroquine
- Leflunomide
- Mycophenolate
- Azathioprine
- Tadalafil
- Dapsone
Repeat prescriptions for sildenafil, folic acid and prednisolone will be issued by your GP.
All other rheumatology medications will be dispensed by the Freeman Hospital outpatient pharmacy for you to collect or delivered by our Home Care service.
Pharmacy opening times: 8.30am – 6pm Monday-Friday and 8.30am -12pm Saturday.
Monitoring
For almost all rheumatology medication some safety monitoring is needed. Your doctor or nurse will ensure you understand this and explain what is needed before and during treatment.
Blood monitoring is done by our dedicated monitoring team. When you start a new drug that needs blood monitoring our nursing team will explain what is needed and our monitoring procedures. Monitoring blood tests are done frequently to start with and then less often. We will contact you by phone to tell you what to do if your blood tests become abnormal.
It is your responsibility to ensure you make and keep appointments for blood monitoring. If your blood tests are not up to date we can not issue a further prescription for your rheumatology drugs.
If you need to rearrange a blood monitoring appointment please contact ABC (our appointments centre) on 0191 282 4444.
It is very important you make appointments to have your bloods checked. This is to ensure your safety. If you do not attend your blood monitoring appointments, we will not be able to prescribe a repeat prescription of your medication, as we cannot be sure they are still safe for you to take.
Blood monitoring is done to check for side effects of treatment. We will contact you by phone to tell you what to do if your blood tests become abnormal.
Anti TNFalpha drugs
Patient information is available below for each of these medications.
Avacopan
Avacopan is also known as Tavneos®. Avacopan is used to treat adults with worsening disease caused by inflammation of the small blood vessels, called vasculitis or granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). You will be given a patient information leaflet if you are started on this drug with further details.
Azathioprine
Visit the Arthritis UK website for more information on azathioprine.
Cyclophosphamide
Visit the Arthritis UK website for more information on cyclophosphamide.
Epoprostenol for Raynaud’s
Epoprostenol is a medication that helps widen blood vessels and improve circulation. In Raynaud’s – especially severe cases or when ulcers develop on the fingers. it can help restore blood flow and reduce pain.
Why it’s used
- Improves blood flow to the fingers
- Helps heal or prevent digital ulcers
- Used when other treatments (like tablets) have not worked well
How it is given
- Epoprostenol is given through a drip (IV infusion) in hospital.
- The infusion usually runs over 3 days, as a day case.
What you might feel
- Headache, flushing, jaw pain, nausea, or light-headedness are common during treatment.
- These usually improve as the dose is adjusted.
Important points
- You will be monitored closely during the infusion.
- Tell your team if you feel unwell, dizzy, or have chest discomfort.
- Because it affects blood pressure, it may not suit everyone.
Hydroxychloroquine
Visit the Arthritis UK website for more information on hydroxychloroquine.
JAK Kinase Inhibitors
Patient information is available below for each of these medications.
Leflunomide
Visit the Arthritis UK website for more information on leflunomide.
Methotrexate
Visit the Arthritis UK website for more information on methotrexate.
Mycophenolate
Visit the Arthritis UK website for more information on mycophenolate.
Other biologics
Patient information leaflets are available below for each of these medications.
- Secukinumab | Side-effects, uses, time to work
- Bimekizumab (Bimlzelx)
- Risankizumab (Skyrizi)
- Ixekizumab (Taltz)
Rituximab
Visit the Arthritis UK website for more information on Rituximab.
Sildenafil/Tadalafil
Using Sildenafil and Tadalafil for Raynaud’s Phenomenon
Why they are used
Raynaud’s causes small blood vessels in the fingers and toes to tighten too much in cold. Sildenafil and tadalafil belong to a group of medicines called PDE-5 inhibitors, which help relax blood vessels. This relaxation can improve blood flow to the hands and feet, reducing:
- Frequency of Raynaud’s attacks.
- Severity of colour changes, pain, and numbness.
- Risk of complications such as digital ulcers (mainly in severe or systemic sclerosis-related Raynaud’s).
How they are taken
- Sildenafil is usually taken three times daily in low doses.
- Tadalafil may be taken as a once-daily low dose because it lasts longer in the body.
Dosing is always tailored by a clinician based on symptoms and tolerability.
Possible side effects
Common side effects include headache, flushing, indigestion, nasal congestion, or dizziness. Because these medicines lower blood pressure slightly, patients who already take blood pressure-lowering medication or have heart issues may need careful monitoring.
Who may benefit
PDE-5 inhibitors are typically considered when:
- First-line treatments (e.g., calcium channel blockers like nifedipine) are ineffective or poorly tolerated.
- The Raynaud’s is severe, particularly in systemic sclerosis.
Important notes
These medications should only be used under medical supervision. They are not suitable for patients who take nitrates or some heart medications, and they may interact with other drugs.
Steroids
Steroids can be given in tablet form, by deep intramuscular injection, by infusion (drip) or directly injected into joints. Your nurse or doctor will explain why you need steroids and what the benefits and side effects might be for you.
More patient information on steroids is available on the Arthritis UK website.
If you are taking steroids for a long time, you will need to know about the ‘steroid sick day rules’. Your doctor or nurse can give you a leaflet about this.
Sulfasalazine
Visit the Arthritis UK website for more information on sulfasalazine.
Tocilizumab
Visit the Arthritis UK website for more information on tocilizumab.
