Health rising blog post, 23 August 2016: Dr Myhill Stripped of her Right to Prescribe Valtrex off label

From an email Dr. Myhill sent to her patients 13 August 2016:

We have a problem with me prescribing valacyclovir.

Yesterday I attended my annual appraisal. This is something all doctors have to do in order to revalidate with the General Medical Council. The appraisal is done by another doctor who looks at all aspects of one’s medical practice to make sure that professional standards are being maintained..

My appraiser was concerned about the idea of me prescribing valacyclovir for EBV post viral chronic fatigue syndromes. Whilst valacyclovir is licensed for acute viral infection it is not licenced for post viral chronic fatigue . What this means is that should anything go wrong, (and that may not even be the prescribing which is at fault), then I would be blamed and be left without any defence. My appraiser would also be part responsible.

If I should go ahead and prescribe valaciclovir for post viral CFS then I would not be revalidated and then I would lose all prescribing rights. The fact that I would be following the guidelines as developed by Dr Martin Lerner is of little or no consequence.

The bottom line is that I cannot prescribe valacyclovir for post viral CFS until either the drug company (Glaxo Smith Kline) has a license to use this drug for post viral chronic fatigue syndrome or I can get ethical committee approval to do this.

Of course I shall be writing to the drug company and also to local ethics committee to see this can be put in place.

In the interim I cannot prescribe valacyclovir for post viral chronic fatigue syndrome. This is very disappointing because I now have several patients who have seen marked benefit as a result of this drug in the prevention of viral flares.”

Find Dr. Lerner’s Guidelines here