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Medication Policies when flying/going on holiday

West Park Surgery Position Statement: Use of Norethisterone/Medroxyprogesterone for Delaying Periods for Holidays in over 16s

Issued: 01/08/24

The surgery recognizes that patients may wish to delay their periods for various personal reasons, including holidays. However, we must prioritize medical necessity for practice appointments. As this is not a clinically urgent reason for an appointment or request, and the medication is available through private providers our surgery will no longer issue prescriptions for norethisterone or any other medications for the purpose of delaying periods solely for holiday convenience.

Rationale

  1. Medical Necessity: Norethisterone/medroxyprogesterone are primarily prescribed for menstrual disorders and other significant medical conditions. Its use for delaying periods for non-medical reasons is not considered essential.
  2. Resource Allocation: The NHS aims to use its resources efficiently to meet the needs of all patients. Prioritizing prescriptions for clinically necessary conditions helps maintain this balance.

Alternatives

Patients seeking to delay their periods for holidays are encouraged to use online services that specialize in such requests. These services provide a convenient and regulated way to obtain the medication. You will likely need a blood pressure reading which you can get from a local chemist or by purchasing a machine from a community pharmacy.

Online Pharmacies:

Norethisterone

Medroxyprogesterone

Additional online pharmacy options can be found through a simple search for “norethisterone online pharmacy,” or “medroxyprogesterone online pharmacy” where many reputable providers offer this service.

Thank you for your understanding and cooperation.

Sincerely,

West Park Surgery

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West Park Surgery Position Statement: Use of benzodiazepines eg diazepam for flying.

Issued: 01/08/24

Going forward, the surgery has taken the decision no longer to prescribe sedative medication for fear of flying due to prescribing guidance and safety concerns. This policy decision has been made by the GP Partners and is adhered to by all prescribers working in the practice. The reasons for this can be found below:

Rationale:

  1. Flight Safety Risks: Although plane emergencies are a rare occurrence there are concerns about diazepam is a sedative that can impair reaction times, concentration, and the ability to respond to emergencies during a flight, posing significant safety risks to both the individual and fellow passengers​.
  2. Legal and Regulatory Compliance: Prescribing diazepam for flight anxiety is not supported by the British National Formulary or NICE guidelines, which contraindicate its use for phobic states and short-term mild anxiety. Furthermore, carrying benzodiazepines into certain countries can be illegal, leading to legal consequences​.
  3. Health Hazards: The sedative effect can increase the risk of deep vein thrombosis (DVT) due to prolonged immobility during non-REM sleep, which is particularly dangerous on long flights​ >4 hours.
  4. Paradoxical Effects: Some individuals may experience increased agitation, aggression, or disinhibition, leading to potential safety and legal issues on board even if they have been ok with the medication on previous uses​. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law. A similar effect can be seen with alcohol, which has led to people being removed from flights.
  5. On Returning Home: Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing, you may fail this having taken diazepam.

Alternative Recommendations: We appreciate a fear of flying is very real and very frightening.  However, there are much better and effective ways of tackling the problem.  We recommend you tackle your problem with a fear of flying courses which are run by several airlines.  They are far more effective than diazepam, have none of the undesirable side effects and the positive effects of the courses continue after the courses have been completed.

These courses provide practical strategies and support to help individuals manage their anxiety without the risks associated with medication.

For those requiring further assistance, consulting with a private GP or travel clinic may be an option. However, our practice prioritizes patient and fellow passengers’ safety and adherence to medical guidelines, hence our decision to discontinue prescribing diazepam for this purpose.

Thank you for your understanding and cooperation.

Sincerely,

West Park Surgery

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