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Senior Lecturer Ruth Savage

MB BS MSc (U Newcastle upon Tyne)

Email ruth.savage@otago.ac.nz
Tel +64 3 364 3603

Ruth has been Senior Lecturer in the Department of General Practice since 2009. She undertakes research in adverse drug reaction monitoring (pharmacovigilance) and rational prescribing and has experience in pharmacoepidemiology studies.

Ruth is responsible for part of the undergraduate general practice teaching modules and is also involved in postgraduate teaching to general practitioners and other health professionals where she emphasises the need to recognize adverse drug reactions and strategies to avoid them or minimise the harm they may cause. The relevance of her teaching and research to clinical practice is in large part due to her extensive clinical experience primarily in rural general practice and also rheumatology.

Ruth is also Senior Medical Assessor in the Centre for Adverse Reactions Monitoring (CARM), New Zealand Pharmacovigilance Centre, Dept of Preventive and Social Medicine, University of Otago, Dunedin where a high proportion of the suspected adverse reaction reports submitted by health professionals are from primary care. She is also an expert advisor to the New Zealand Medicines Adverse Reactions Committee.

As a consultant to the Uppsala Monitoring Centre, WHO Collaborating Centre for International Drug Monitoring, Uppsala, Sweden Ruth also undertakes research and provides training in international pharmacovigilance.

Research Interests

  • Pharmacovigilance and Rational Prescribing
  • Detection of previously unrecognized adverse drug reactions (ADRs) and interactions in national and international databases of ADR reports.
  • Assessing if the outputs from automated methods of detecting suspected adverse reactions from large databases are clinically relevant.
  • Assessment of ADR case reports to determine risk factors for individual ADRs.
  • Assessment of ADR case reports to determine if prescribing behaviour has allowed specific ADRs or interactions to occur and how this can be modified.

Summer Student Supervision

2017-18

Jamie Go
Topic: Diabetes care in general practice - Access to the Retinal Screening Pathway
Supervisor(s): Dr Ruth Savage and Deborah Callahan
Sponsor: Pegasus Health (Charitable) Trust

2015-16

Anna Hulme
Topic: Evaluation of a Telephone Based Brief Intervention Model for Smoking Cessation
Supervisor(s): Leigh Aston and Dr Ruth Savage
Sponsor: Pegasus Health (Charitable) Trust

2012-13

Lucy Peterson
Topic: Reducing barriers to practice nurse involvement in general cervical screening and understanding effective methods of inviting and engaging priority women in cervical screening in general practice.
Supervisors Ruth Savage, Kim Burgess, Jackie Cooper
Sponsor: Partnership Health Canterbury PHO

2011-12

Nicole Sycamore
Topic: Drug utilisation study of paracetamol in the community in children aged under twelve years through paracetamol questionnaires.
Supervisors: Ruth Savage, Kathryn Henshaw
Sponsor: Pegasus Health

2010-11

Talia Wise
Topic: Why do General Practitioners and practice nurses differ in their behaviours and attitudes towards performing and coding of CVD risk assessment?
Supervisors: Ruth Savage, Pip Mason
Sponsor: Partnership Health Canterbury

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Publications

Savage, R. L., & Tatley, M. V. (2018). Case series analysis of New Zealand reports of rapid intense potentiation of warfarin by roxithromycin [Short communcation]. Drug Safety, 41(5), 515-521. doi: 10.1007/s40264-017-0634-y

Kuan, I. H. S., Duffull, S. B., Savage, R. L., & Wright, D. F. B. (2018, August). Should we use metformin in patients with chronic renal impairment? A systematic review of published metformin associated lactic acidosis cases. Verbal presentation at the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists New Zealand Section (ASCEPT-NZ) Annual Scientific Meeting, Queenstown, New Zealand.

Savage, R. L., Castellano, M., & Tatley, M. V. (2017). International reports of unexpected low plasma concentrations of dabigatran suggest that more frequent measurements will add value. Seminars in Thrombosis & Hemostasis, 43(6), 635-638. doi: 10.1055/s-0037-1603361

Savage, R., & Tatley, M. (2017). Rapid onset of very high INR values when roxithromycin prescribed with warfarin challenges the accepted mechanism. Drug Safety, 40(10), (pp. 963-964). doi: 10.1007/s40264-017-0580-8

Savage, R., Tatley, M., & Kunac, D. (2017, July). Fifty years of adverse drug reaction reporting in New Zealand: Primary care involvement and the developing use of e-health. Verbal presentation at the Royal New Zealand College of General Practitioners (RNZCGP) Conference for General Practice Quality Symposium, Dunedin, New Zealand.

Journal - Research Article

Maggo, S. D. S., Savage, R. L., & Kennedy, M. A. (2016). Impact of new genomic technologies on understanding adverse drug reactions. Clinical Pharmacokinetics, 55(4), 419-436. doi: 10.1007/s40262-015-0324-9

Savage, R. L., Zekarias, A., & Caduff-Janosa, P. (2015). Varenicline and abnormal sleep related events. Sleep, 38(5), 833-837. doi: 10.5665/sleep.4686

Savage, R. L., Star, K., & Hill, R. (2012). Severe muscle symptoms with lipid-lowering agents may be confused with neurogenic claudication associated with spinal canal stenosis. International Journal of Risk & Safety in Medicine, 24(4), 215-219. doi: 10.3233/jrs-2012-0577

Harrison-Woolrych, M., Maggo, S., Tan, M., Savage, R., & Ashton, J. (2012). Cardiovascular events in patients taking varenicline: A case series from intensive postmarketing surveillance in New Zealand. Drug Safety, 35(1), 33-43. doi: 10.2165/11597690-000000000-00000

Savage, R. L., Kunac, D. L., & Johansson, J. (2009). Appraising the post-marketing safety of medicines: A description of national and international pharmacovigilance with a focus on medicines used in chronic pain. Current Anaesthesia & Critical Care, 20(5-6), 215-220. doi: 10.1016/j.cacc.2009.07.013

Gwynne Jones, D. P., Savage, R. L., & Highton, J. (2008). Alendronate-induced synovitis. Journal of Rheumatology, 35(3), 537-538.

Jenks, K. A., Stamp, L. K., O'Donnell, J. L., Savage, R. L., & Chapman, P. T. (2007). Leflunomide-associated infections in rheumatoid arthritis. Journal of Rheumatology, 34, 2201-2203.

Tatley, M., & Savage, R. (2007). Psychiatric adverse reactions with statins, fibrates and ezetimibe: Implications for the use of lipid-lowering agents. Drug Safety, 30(3), 195-201.

Savage, R. L., Highton, J., Boyd, I. W., & Chapman, P. (2006). Pneumonitis associated with leflunomide: A profile of New Zealand and Australian reports. Internal Medicine Journal, 36, 162-169.

Gwynne Jones, D., Savage, R., & Highton, J. (2005). Synovitis induced by alendronic acid can present as acute carpal tunnel syndrome. BMJ, 330, 7482, 74. doi: 10.1136/bmj.330.7482.74

Savage, R. (2005). Cyclo-oxygenase-2 inhibitors: When should they be used in the elderly? Drugs & Aging, 22(3), 185-200.

Savage, R. (2005). Thiazolidinediones and lowered high density lipoprotein cholesterol. WHO Signal, February, 6-8.

Coulter, D. M., Clark, D. W., & Savage, R. (2003). Celecoxib, rofecoxib, and acute temporary visual impairment. British Medical Journal, 327, 1214-1215.

Savage, R. (2002). Loratadine. WHO Pharmaceuticals Newsletter, (2), 12.

Savage, R. (2002). A dangerous trio. Medsafe Prescriber Update, 23(2), 20.

Savage, R. (2002). Venous thromoembolism with Diane 35 TM and Estelle 35TM. Medsafe Prescriber Update, 23, 2-3.

Savage, R. (2002). Proton pump inhibitors. WHO Pharmaceuticals Newsletter, (2), 12.

Savage, R. (2002). Can patients stomach COX-2 inhibitors? Medsafe Prescriber Update, 23(2), 18-19.

Savage, R. (2001). Nonsteroidal anti-inflammatory medicines and lower gastrointestinal tract damage. Prescriber Update, 21, 25-27.

Savage, R. (2001). Tiaprofenic-acid and cystitis. Prescriber Update, 2, 18-21.

Savage, R., & Coulter, D. M. (2000). Oral contraceptives and venous thromboembolism [Letter]. New Ethicals Journal, 24.

Savage, R. (2000). Omeprazole-induced interstitial nephritis. Prescriber Update, 20, 11-13.

The ADR Signals Analysis Project (ASAP) Team, including Savage, R. (1997). How does cystitis affect a comparative risk profile of tiaprofenic acid with other nonsteroidal antiinflammatory drugs? An international study based on spontaneous reports and drug usage data. Pharmacology & Toxicology, 80(5), 211-217. doi: 10.1111/j.1600-0773.1997.tb01962.x

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Journal - Research Other

Savage, R. L., & Tatley, M. V. (2018). Case series analysis of New Zealand reports of rapid intense potentiation of warfarin by roxithromycin [Short communcation]. Drug Safety, 41(5), 515-521. doi: 10.1007/s40264-017-0634-y

Savage, R. L., Castellano, M., & Tatley, M. V. (2017). International reports of unexpected low plasma concentrations of dabigatran suggest that more frequent measurements will add value. Seminars in Thrombosis & Hemostasis, 43(6), 635-638. doi: 10.1055/s-0037-1603361

Savage, R. (2016). Vemurafenib and atrial fibrillation: Signal strengthening. WHO Pharmaceuticals Newsletter, 1, 17-22. Retrieved from http://www.who.int/medicines/publications/newsletter/en/

Castellano, M., Sartori, D., & Savage, R. (2016). Dabigatran and thromboembolism: Analysis of case histories for risk factors. WHO Pharmaceuticals Newsletter, 3, 15-22. Retrieved from http://www.who.int/medicines/publications/newsletter/en/

Savage, R. (2015). Brentuximab and hepatic disorders. WHO Pharmaceuticals Newsletter, 2, 17-22. Retrieved from http://www.who.int/medicines/publications/PharmaNewsletter2_15/en/

Wells, J. E., Cross, N. B., Savage, R. L., Parkin, L., Horsburgh, S., & Richardson, A. K. (2015). Renal replacement therapy associated with lithium nephrotoxicity in New Zealand. New Zealand Medical Journal, 128(1425). Retrieved from http://www.nzma.org.nz/journal

Savage, R. (2014). Tocilizumab: Psoriasis and aggravated psoriasis. WHO Pharmaceuticals Newsletter, 2, 16-21. Retrieved from http://www.who.int/medicines/publications/PharmNewsletter2_14/en/

Savage, R. (2013). The New Zealand Centre for Adverse Reactions Monitoring: A source of practice-based evidence. Journal of Primary Health Care, 5(2), 170-173. doi: 10.1071/HC13170

Savage, R. (2012). Dronedarone, hyperthyroidism and decreased thyroid stimulating hormone. WHO Pharmaceuticals Newsletter, 4, 14-18. Retrieved from http://www.who.int/medicines/publications/PharmNewsletter4_12/en/

Savage, R. (2012). Venlafaxine, pre-eclampsia, eclampsia and related disorders of pregnancy. WHO Pharmaceuticals Newsletter, 1, 19-22. Retrieved from http://www.who.int/medicines/publications/PharmNewsletter1_12/en/

Savage, R. L. (2010). Leflunomide in combination therapy for rheumatoid arthritis [Editorial]. Drug Safety, 33(6), 523-526. doi: 10.2165/11532390-000000000-00000

Meyboom, R. H. B., Star, K., Bate, J., Savage, R., & Edwards, I. R. (2008). TNF-α inhibitors and leukaemia: International pharmacovigilance reports [Letter to the editor]. Drug Safety, 31(5), 445-447. doi: 10.2165/00002018-200831050-00013

Savage, R. (2007). Serious reactions with tramadol: Seizures and serotonin syndrome. Prescriber Update, 28(1), 11-13.

Ng, J., Savage, R., & McQueen, F. (2005). Churg-Strauss vasculitis syndrome and leukotriene receptor antagonists [Research Letter]. Annals of the Rheumatic Diseases, 64, 1382.

Savage, R. L., & Kiuru, A. (2005). Thiazolidinediones and lowered HDL cholesterol [Research Letter]. Diabetes Care, 28(9), 2329-2330.

Savage, R., & Tatley, M. (2004). Myopathy with statins: Check CK levels and interactions. Prescriber Update, 25(1), 4-5.

Savage, R. (1997). Oral contraceptives and venous thromboembolism [Letter]. New Zealand Medical Journal, 107, 109.

Savage, R. (1997). Current debate: Oral contraceptives and venous thromboembolism. PreMec Bulletin, November.

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Journal - Professional & Other Non-Research Articles

Savage, R. (2013). Donepezil: Syncope, heart block and beta-adrenergic blockade. Prescriber Update, 34(3), 30. Retrieved from http://www.medsafe.govt.nz/publications/prescriber-update.asp

Savage, R. (2006). Leflunomide and Pneumonitis. Prescriber Update, 27(1), 7-8.

Savage, R. (2006). Evidence for Tramadol-Warfarin interaction. Prescriber Update, 27(2), 23-24.

Savage, R. (2006). Interstitial nephritis with PPIs on the rise. New Zealand Doctor, (October), 22.

Savage, R. (2006). Alendronate and inflammatory adverse reactions. Prescriber Update, 27(1), 4-6.

Savage, R., & Rademaker, M. (2005). Topical corticosteroids: Face facts. Prescriber Update, 26(2), 30-31.

Pettersson, M., & Savage, R. L. (2002). Cyclo-oxygenase 2 inhibitors and sudden death. Drugs of Current Interest, (December). USA: Uppsala Monitoring Centre.

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Conference Contribution - Published proceedings: Abstract

Savage, R., & Tatley, M. (2017). Rapid onset of very high INR values when roxithromycin prescribed with warfarin challenges the accepted mechanism. Drug Safety, 40(10), (pp. 963-964). doi: 10.1007/s40264-017-0580-8

Tatley, M., Savage, R., Kunac, D., & Ashton, J. (2016). Years of pharmacovigilance in New Zealand: Lessons in sustainability and growth. Drug Safety, 39(10), (pp. 1001). doi: 10.1007/s40264-016-0445-6

More publications...