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SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Supply Issues Information
Intermittent supply problems can occur due to either manufacturing issues causing shortages of branded products (‘Manufacturer Cannot Supply’, MCS) or supply issues affecting medicines, resulting in generics being difficult to obtain at Scottish Drug Tariff Part 7 (SDT) prices, or at all.
Information on Part 7 generic medicines which are identified as being in short supply is available via the Community Pharmacy Scotland Website which indicates the revised Part 7 prices for agreed shortages. Community Pharmacists are advised to report problems with obtaining Part 7 items at Tariff prices via the Community Pharmacy Scotland Shortages Reporter
The advice in this document is not intended to serve as a standard of medical care or be applicable in every situation. Decisions regarding the treatment of individual patients must be made by the clinician in light of that patient’s presenting clinical condition and with reference to current good medical practice.
This document is available via the NHS Forth Valley Intranet:
https://staffnet.fv.scot.nhs.uk/a-z/pharmacy/area-wide/supply-issues-information/
Entries which have been updated from the previous version are marked as ‘NEW’ or ‘UPDATED’ in the ‘Date Information Last Checked’ column.
A commercial Drug Shortages Tracker is also provided by MIMS to subscribers: https://www.mims.co.uk/drug-shortages-live-tracker/article/1581516
Supply issues are constantly in flux and your local Community Pharmacists will be able to give you up to date advice on availability.
Medicine Supply Alert Notices are now issued by the Scottish Government and are an additional source of information and advice – these should be used in conjunction with the information in this document which gives localised advice. NB: where Parallel Imports are stated to be available, these are the preferred option as these are licensed products in the UK. Unlicensed imports are not recommended for routine use – Community Pharmacies will require authorisation via the Specials process for Unlicensed Imports.
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Contents Supply Issues Information ................................................................................................................................................................................................................. 1
BNF Chapter 1 – Gastro-intestinal System .................................................................................................................................................................................... 3
BNF Chapter 2 – Cardiovascular System ..................................................................................................................................................................................... 10
BNF Chapter 3 – Respiratory System .......................................................................................................................................................................................... 13
BNF Chapter 4 – Central Nervous System ................................................................................................................................................................................... 15
BNF Chapter 5 – Infections ......................................................................................................................................................................................................... 26
BNF Chapter 6 – Endocrine System ............................................................................................................................................................................................ 27
BNF Chapter 7 – Obstetrics, gynaecology and urinary tract disorders ...................................................................................................................................... 28
BNF Chapter 8 – Immune system and malignant disease .......................................................................................................................................................... 29
BNF Chapter 9 – Nutrition and Blood ......................................................................................................................................................................................... 30
BNF Chapter 10 – Musculoskeletal and Joint Diseases ............................................................................................................................................................... 31
BNF Chapter 11 – Eye .................................................................................................................................................................................................................. 32
Royal College of Ophthalmologists and the UK Ophthalmic Pharmacy Group maintain a shortages page. .............................................................................. 32
Additional local advice is included below. .................................................................................................................................................................................. 32
BNF Chapter 12 – Ear, Nose and Oropharynx ............................................................................................................................................................................. 33
BNF Chapter 13 – Skin ................................................................................................................................................................................................................. 34
BNF Chapter 14 – Immunological products and vaccines ........................................................................................................................................................... 35
BNF Chapter 15 – Anaesthesia .................................................................................................................................................................................................... 36
Other ........................................................................................................................................................................................................................................... 37
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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BNF Chapter 1 – Gastro-intestinal System
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Bisacodyl 5 mg and 10 mg suppositories
5 mg out of stock until early March 2021
10 mg out of stock until March
2021
MSAN(2020)117 advises on supply problems with bisacodyl (Ducolax) 5 mg and 10 mg suppositories. Advice and Actions Where patients have insufficient supplies to last until the re-supply date, clinicians should:
review if treatment is still required
consider switching to alternative preparations (see BNF and MSAN) for additional information.
counsel patients on the different products and dosing regimen prescribed.
08/01/2020 Updated
Docusate sodium 100mg capsules
Limited availability until April2021
Check stock availability with local community pharmacy
Docusate sodium 50mg/5ml oral solution remains available.
Alternative laxatives remain available.
08/01/2021 updated
Famotidine, Cimetidine and Nizatidine
Famotidine Limited supplies. Nizatidine out of stock until
Jan 2021/Feb 2021 Cimetidine all strength out of
stock until June 2021.
MSAN(2020)108 advises on supply problems with various H2 antagonists, secondary to the supply issue with Ranitidine.
Cimetidine – all strengths out of stock until June 2021.
An oral solution is available (200mg/5ml).
Famotidine 20 mg and 40 mg tablets are available in
08/01/2021 updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
limited supply; however, stock changes frequently –
check availability with local community pharmacy.
Nizatidine 150 mg and 300 mg capsules are unavailable;
however, stock changes frequently – check availability
with local community pharmacy.
It is recommended that, where possible, patients are not
switched to an alternative H2-receptor antagonist in the
first instance as this may exacerbate a shortage of these
products. There are currently sufficient supplies of oral
omeprazole to manage an increase in demand.
Advice and Actions
For patients without sufficient supplies of cimetidine,
famotidine and nizatidine for the duration of the out of
stock period, prescribers should consider the following
advice:
Review patients to establish if ongoing treatment is still
required.
Review patients to establish if treatment could be
stepped down to an antacid or alginate.
If ongoing treatment is still required, then consider
switching to an alternative oral treatment
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Sterculia 62% with frangula bark 8%
granules (Normacol Plus)
Out of stock until February 2021
If community pharmacy cannot obtain then consider alternative.
Recommendation is to switch to ispaghula husk instead, if
clinically appropriate
08/01/2021 updated
Pancrex V and Pancrex V 125mg capsules
Resolved
08/01/2021 updated
Prednisolone 5mg suppositories
Out of stock until end January2021
MSAN(2020)106 advises on supply problems with prednisolone 5mg suppositories.
13/01/21 updated
Salofalk® (mesalazine) 1g suppositories
Resolved
09/12/2020 Updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Salazopyrin EN (Sulfasalazine) gastro-
resistant 500mg tablets Resolved
08/01/2021
updated
Sulfasalazine 250mg/5mL oral suspension
Resolved
19/12/2020
Updated
Ranitidine – ALL formulations
All oral formulations of ranitidine are anticipated
to be out of stock, with no
date for resupply until further notice
An updated Supply Alert Notice - MSAN (2020)54 has
been issued by the Scottish Government.
The main points are below. See-MSAN (2020)54 for full
information.
Ranitidine tablets, effervescent tablets and oral solution are
expected to be out of stock with no date for resupply until further
notice.
Ranitidine injection is now also expected to be out of stock from the
end of May 2020 with no date for resupply until further notice.
Extremely limited supplies remaining in wholesalers and
pharmacies, which have not been recalled by the MHRA, are
available and can be supplied (some local pharmacies may have
09/12/2020
Reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
some existing stock).
No new patients should be initiated on treatment with ranitidine
oral or injectable products.
All patients should be reviewed as repeat prescriptions are
requested and if ongoing treatment is required, be switched to
clinical alternatives
It is recommended that, where possible, patients are not switched
to an alternative H2-receptor antagonist in the first instance as this
may exacerbate a shortage of these products. There are currently
sufficient supplies of oral omeprazole to manage an increase in
demand.
Local Advice is as follows:
Based on DoH1 guidance and previous advice our current FV
advice is:
1. Review all patients prescribed H2R antagonists and confirm
patient requires gastrointestinal (GI) protection.
2. Patients should firstly be reviewed for the need for GI
protection. In patients where GI protection is not required; trial
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
use of Peptac® for 2-4 weeks.
3. If symptoms persist or for those patients requiring GI
protection: suitability of a proton pump inhibitor (PPI) should be
reviewed2:
For patients to be started on a PPI ensure no contra-indications:
omeprazole is first-line PPI of choice
If omeprazole is unsuitable lansoprazole may be an alternative PPI
3. If PPI not suitable: patients to be switched to an alternative
H2R antagonist: famotidine (less cost-effective option) or
cimetidine (depending on suitability of interaction profile) could
be used as alternative H2R antagonists however stock of these
is extremely limited2.
5. For palliative patients requiring SC ranitidine contact the
palliative care team for advice and guidance for an alternative.
https://www.sehd.scot.nhs.uk/publications/MSAN(2020)39.pdf
https://www.sehd.scot.nhs.uk/publications/MSAN(2020)25.pdf
https://www.sehd.scot.nhs.uk/publications/MSAN(2020)35.pdf
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Paediatric patients
Check if patient still symptomatic and switch to omeprazole
dispersible tablets / MUPS if required.
For patients requiring a 5mg dose of omeprazole –
Omeprazole (Losec) MUPS tablets can be halved (and no more),
where appropriate, and dispersed in 5ml or 10ml of tap
water/boiled and cooled water, for 5mg or 10mg dose respectively.
Do not crush the tablet. Doses must be rounded to the nearest 5mg
as otherwise dose accuracy cannot be guaranteed.
Where omeprazole dispersible tablets/MUPS are not suitable
licensed omeprazole suspension is now available.
Further information is available in the MSAN
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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BNF Chapter 2 – Cardiovascular System
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Clonidine 25 microgram tablets
Resolved
09/12/2020 Updated
Enalapril 20mg tablets Resolved
08/01/2021
Updated
Isosorbide mononitrate modified release (Isotard
XL) 50 mg tablets
Out of stock until w/c 18 January 2021
Kyowa Kirin sole supplier out of stock until w/c 18 January 2021.
Limited emergency stock is available for order through Kyowa Kirin Medical Information: [email protected].
Isosorbide mononitrate 50mg modified release capsules remain available.
08/01/2021 New
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Bile Acid Sequestrants: Colestyramine (Questran) Oral Powder Sachets and
Colestipol (Colestid Orange)
Colestyramine - ongoing supply
issues not expected to be
resolved until Q3 2021
Colestid orange sachets are out
of stock until May 2021
.
Generic colestyramine 4g light sachet available.
Colestid plain sachets are currently available.
08/01/2021 Reviewed
Metoprolol Tablets (50mg and 100mg)
Resolved
13/01/2021 updated
Prazosin (Hypovase) 1mg Tablets
Unavailable with no resupply date
500 microgram tablets are available
Mental Health Pharmacy Colleagues have previously provided advice in the event that the tablets cannot be sourced. Use of the unlicensed product is not advocated in the first instance.
08/01/2021
Reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Valsartan 40mg, 80mg and 160mg
Limited availability There are ongoing intermittent supplies of valsartan. Check stock availability with local community pharmacy.
08/01/2021
Reviewed
Zemtard® (diltiazem) 240mg XL capsules
Out of stock until week commencing 1st February 2021
Check stock availability with local community pharmacy.
Adizem® and Viazem® (diltiazem) XL 240mg once daily capsules remain available; do not change to Zemtard® (diltiazem) 2x 120mg XL capsules as there is insufficient supply of this product to support demand.
If brand is changed advise patient to report any side effects or changes in their symptom control to their GP.
08/01/2021
New
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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BNF Chapter 3 – Respiratory System
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Emerade (adrenaline) 150, 300, and 500 microgram
All strengths unavailable for the foreseeable
future
The MHRA have issued an updated Supply Alert in December with updated advice. See the Supply Alert full advice and clear advice on utilising available supplies and avoidance of over-supply.
Patient level recalls of Emerade 150mcg (04/03/2020) and 300mcg (07/04/2020) and 500mcg (18/5/2020).
08/01/2021
reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Sodium cromoglicate (Intal®) CFC-free 5mg
inhaler
Out of stock until March 2021
Where the patient has insufficient supplies to last until the
resupply date, clinicians should consider:
Sodium cromoglicate inhaler (Intal) is non-
Formulary in Forth Valley
BTS guidelines consider inhaled corticosteroids to
be the first choice preventer drug, sodium
cromoglicate is an alternative but less effective
preventer therapy
If treatment with sodium cromoglicate is
considered necessary and the patient has
insufficient supplies to last until the resupply date,
unlicensed imports can be obtained by Community
Pharmacy (Pharmacies will require to follow the
Specials Authorisation process before obtaining).
08/01/2021
reviewed
Sodium cromoglicate (Nalcrom) 100 mg capsules
Resolved
09/12/2020
Updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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BNF Chapter 4 – Central Nervous System
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Alprazolam (Xanax) 250mcg tablets
Out of stock expected Jan 2021.
If community pharmacy unable to source stock limited supplies of alprazolam 500mcg tablets available.
The 500mcg tablets are scored and can be broken in half, however, the score line only facilitates breaking for ease of swallowing and may not divide into equal doses.
08/01/2021
reviewed
Butec (buprenorphine) 15 microgam/hour patch
Out of stock until mid January 2021
Check with Community Pharmacy alternative brands that they can obtain.
Cost effective alternatives are Sevodyne and Reletrans; Butrans is a more expensive option.
Issue acute prescription accordingly by brand name as a temporary measure.
Butec 5 and 10 microgram patches remain available.
08/01/2021
updated
Cloral betaine 707mg tablets Out of stock until Q2 2021
Relatively expensive, consider alternative instead.
Unlicensed specials are available through Alliance
Healthcare. Community Pharmacies will require
to follow the unlicensed Specials process.
08/01/2021
Reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Depakote (Valproate
semisodium) 250mg tablets
Resolved
09/12/2020 Updated
Entacapone 200mg tablets Resolved
08/01/2021
Resolved
Epanutin (phenytoin) 50mg Chewable Infatabs
Resolved
09/12/2020
Updated
Fluoxetine 10mg tablets Out of stock until March
2021
Fluoxetine 10 mg capsules remain available. Community Pharmacists may supply 10mg capsules against a 10mg tablets script, with appropriate endorsements, following the FV and CPS Shortages guidance as noted in MSAN(2020)16.
08/01/2021
Reviewed
Fluoxetine 30 mg capsules Out of stock until mid-
March 2020 Fluoxetine 10mg and 20mg capsules remain available.
08/01/2021 Updated
Galantamine 8mg and 12mg
immediate release tablets Discontinued
Galantamine modified release capsules (8mg, 16mg, 24mg) and galantamine 4mg/ml oral solution are available. UKMi guidance for switching preparations below: It is recommended that the same total daily dose of galantamine is administered to patients. Patients
02/11/2020
Updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
switching to the once-daily regimen should take their last dose of galantamine tablets or oral solution in the evening and start prolonged- release capsules once daily the following morning.
Haloperidol (Serenace®) 500 microgram capsules
Discontinued
Haloperidol 500 microgram tablets remain available.
Advice and Actions
For patients who require a supply of haloperidol (Serenace®) 500 microgram capsules community pharmacists can substitute haloperidol 500 microgram tablets with suitable endorsement.
For patients unable to swallow a tablet, Haloperidol (Haldol®) 2mg/ml oral solution is available if appropriate.
UK Medicines Information (UKMi) has confirmed that haloperidol capsules and tablets are bioequivalent to the oral solution.
09/12/2020 Updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Haloperidol 5mg/5ml oral solution sugar free
Out of Stock until March
2021
MSAN(2020)110
Haloperidol 5mg/5ml oral solution sugar free out of stock until March 2021. If Community Pharmacy are unable to supply. Consider alternatives -
1. Switching patients able to swallow solid dosage forms to haloperidol tablets (available as 500mcg, 1.5mg, 5mg and 10mg tablets)
2. Prescribe licensed Haloperidol (Haldol®) 2mg/ml oral solution ensuring patients are counselled on the change in strength and dose
3. Prescribing haloperidol 5mg/5ml oral solution sugar free as an unlicensed Special - Community Pharmacies will require to follow the unlicensed Specials process – obtaining authorisation for the unlicensed Special.
08/01/2021 Reviewed
Levodopa/carbidopa/entacapone tablets – ( Sastravi®) various
strengths
Resolved
09/12/2020 updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Lithium carbonate (Priadel)
200mg and 400mg tablets
(Essential Pharma)
Resolved - Essential pharma have withdrawn the
discontinuation notice for Priadel tablets therefore supplies will continue to
remain available although quotas are in place.
13/11/2020
updated
Mianserin 10mg and 30mg tablets
Out of stock until Q2 2021
Unlicensed imports may be available. Community Pharmacies will require to follow the unlicensed Specials process – obtaining authorisation for the unlicensed Special.
08/01/2021
Reviewed
Mirtazapine 15 mg, 30mg and 45 mg orodispersible tablets
Resolved
09/12/2020
updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Moclobemide 150mg and 300mg tablets
Limited availability Mylan (Manerix) now have both strengths back in stock
Generic supplies expected March 2021 (300mg) and July 2021 (150mg).
08/01/2021 Reviewed
Nardil (Phenelzine) tablets Out of stock – no resupply
date
MSAN (2020) 63 advises on current supply problems.
Given the difficulties in withdrawing treatment and
initiating new treatments in patients stabilized on
phenelzine – patients should be maintained on
phenelzine using unlicensed imports where supply is
required while UK product is unavailable. Community
Pharmacies will require to follow the unlicensed Specials
process – obtaining authorisation for the unlicensed
Special. The UKMI Specialist Pharmacy Service have
produced an advisory memo.
Ongoing supplies of imported products are becoming
increasingly sporadic. Local Mental Health services are
advising that patients are reviewed in conjunction with
their Mental Health Consultant, with a view to down
titration and switching to an alternative agent where
possible. Supplies of an unlicensed Special capsule
08/01/2021
reviewed
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
formulation are available as a short-term option to
manage these patients during review. Community
Pharmacies will require to follow the unlicensed Specials
process – obtaining authorisation for the unlicensed
Special.
Pethidine 50mg tablets Out of stock expected
February 2021
Patients with insufficient supplies of pethidine 50mg tablets should be: • reviewed to assess ongoing need and advice obtained from their local pain team and/or substance misuse team on choice of alternative agent or advice on weaning MSAN (2020)78
08/01/2021
Updated
Phenytoin Sodium NRIM 100mg
capsules
Unavailable - no date of
recovery
A Supply Alert (MSAN(2020)60) has been issued with advice for prescribers (Phenytoin is a Category 1 anti-epileptic) – Therapeutic Blood Monitoring will be required before switching to the alternative brand (Flynn Pharma) and 2 weeks after switching and monitored as per the Supply Alert.
1. Patients with a generic prescription (and no indication brand in name or directions) these patients will need to be contacted to find out which brand they are currently being dispensed.
a. Those currently dispensed NRIM product
08/01/2021 Reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
should be advised to make an appointment to get a phenytoin blood level done before their current supply runs out (as per the Supply Notice). The Supply Notice advises a repeat blood test 2 weeks after they have switched, so the patient will need to ensure they contact the Practice to arrange this follow-up test, depending on when they actually switch. The repeat prescription should be amended to the Flynn Pharma product (“Phenytoin sodium 100mg capsules (Flynn Pharma Ltd)”).
b. Those currently getting Flynn Pharma should have their repeat amended to this description (the FV EMIS Formulary version – “Phenytoin sodium 100mg capsules (Flynn Pharma Ltd)”).
2. Patients with a generic description prescription and
NRIM in the dosage directions. These patients should be advised to make an appointment to get a phenytoin blood level done before their current supply runs out (as per the Supply Notice). The Supply Notice advises a repeat blood test 2 weeks after they have switched, so the patient will need to ensure they contact the Practice to arrange this follow-up test, depending on when they actually switch. The repeat prescription
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
should be amended to the “Phenytoin sodium 100mg capsules (Flynn Pharma Ltd)” product.
3. Patients with a branded NRIM script These patients should be advised to make an appointment to get a phenytoin blood level done before their current supply runs out (as per the Supply Notice). The Supply Notice advises a repeat blood test 2 weeks after they have switched, so the patient will need to ensure they contact the Practice to arrange this follow-up test, depending on when they actually switch. The repeat prescription should be amended to the “Phenytoin sodium 100mg capsules (Flynn Pharma Ltd)” product.
4. Patients with a generic description prescription and Flynn in the dosage directions. The repeat prescription should be amended to the Flynn Pharma product.
The advice in the Supply Notice should be followed. In the event of any further additional local advice this document will be updated and prescribers and pharmacists notified.
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 24 of 37
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Promazine 25mg and 50mg
tablets Resolved
09/12/2020
Updated
Trifluoperazine (Stelazine)
1mg/5ml syrup Out of stock until April 2021
If Community Pharmacy unable to supply consider switching to trifluoperazine tablets.
For those unable to swallow tablets consider trifluoperazine 5mg/5ml oral solution, ensuring patients are counselled on the change in strength and equivalent volume required
08/01/2021 Reviewed
Zonisamide 25 mg, 50 mg and
100 mg capsules Limited availability
MSAN(2020)107 advises on the ongoing intermittent
supplies of zonisamide capsules.
Check stock availability with local community pharmacy.
08/01/2021 reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 25 of 37
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Zyban (bupropion) 150mg MR
Tablets Resolved
09/12/2020 updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 26 of 37
BNF Chapter 5 – Infections
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Tuberculosis (TB) Products
See MSAN(2020)94 for info on availability
The Scottish Government have issued an update (MSAN(2020)94)on current supply issues
08/01/2021
reviewed
Rifampicin (Rifadin) 100mg/5ml oral
suspension Resolved
08/01/2021
updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 27 of 37
BNF Chapter 6 – Endocrine System
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Desmopressin nasal
formulations
Supply issue with various
formulations until mid-2021
MSAN(2020)101 advises on the ongoing supplies of
DDAVP® (Desmopressin) 0.01% w/v (100 micrograms/ml)
intranasal solution.
Supplies of desmopressin 100micrograms/ml nasal spray (10 micrograms per actuation) remain available from Aspire Pharma Ltd for patients on doses of 10 microgram or more. MSAN(2020)95 advises on the ongoing intermittent
supplies of Desmopressin (Octim® ) 150 micrograms per
actuation nasal spray. Desmopressin (Octim) 15
micrograms per ml injection remains available and can be
prescribed as an alternative - see MSAN for advice.
08/01/2021
reviewed
HRT Products
Supply Issues with various HRT
products
Further information on supply issues is available here The British Menopause Society also has associated information.
08/01/2021
reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 28 of 37
BNF Chapter 7 – Obstetrics, gynaecology and urinary tract disorders
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Brevinor
(ethinylestradiol/norethisterone)
35microgram / 1mg tablets
Out of Stock until late Jan 2021 See MSAN(2020)98 for information on a
number of Oral Contraceptive issues 08/01/2021
reviewed
Norimin
(ethinylestradiol/norethisterone)
0.035mg/1mg tablets
Out of Stock until early Feb 2021
See MSAN(2020)98 for information on a number of Oral Contraceptive issues
08/01/2021 reviewed
Synphase (Ethinylestradiol And
Norethisterone) Tablets
Out of Stock until early Feb
2021
See MSAN(2020)98 for information on a number of Oral Contraceptive issues
08/01/2021 reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 29 of 37
BNF Chapter 8 – Immune system and malignant disease
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 30 of 37
BNF Chapter 9 – Nutrition and Blood
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Pregaday® Tablets (Ferrous Fumarate 322mg/Folic Acid
0.35mg)
Out of stock until late January 2021
MSAN(2020)103 advises on supply problems with Pregaday. Advice and action:
Prescribe individual components as iron and folic acid.
FV Formulary 1st line choice iron supplement is ferrous fumarate
08/01/2021
reviewed
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 31 of 37
BNF Chapter 10 – Musculoskeletal and Joint Diseases
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Meloxicam 7.5mg tablets
Resolved
08/01/2021 updated
Neostigmine bromide 15mg tablets
Discontinued Alliance Pharma, sole supplier has discontinued
Discuss alternatives with specialist.
09/12/2020 Reviewed
Penicillamine 250 mg tablets
Limited availability
Kent Pharmaceuticals are out of stock until January 2021.
Mylan have supplies of penicillamine 125mg and 250mg tablets.
01/08/2020 updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 32 of 37
BNF Chapter 11 – Eye
Royal College of Ophthalmologists and the UK Ophthalmic Pharmacy Group maintain a shortages page. Additional local advice is included below.
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Acetazolamide Slow Release 250mg capsules
Resolved
09/12/2020 Updated
Chloramphenicol (Eykappo) 5mg/ml
Preservative Free Eye Drops 10ml
Out of stock until Q1 2021
Aspire Pharma, sole supplier of a multidose preservative
free chloramphenicol eye drop, have supplies of short
dated stock available (expiry 31/12/2020).
• Further resupply is expected during Q1 2021.
• Minims Chloramphenicol 0.5% single-use eye drops
remain available for patients who require a preservative
free formulation once supplies of Eykappo are
unavailable.
08/01/2021 Reviewed
Lacri-lube Ointment Remains unavailable –
no date available The Royal College of Ophthalmology recommends Xailin Night Ointment as an alternative
08/01/2021 Reviewed
Sofradex Ear/Eye Drops Out of Stock until late January
2021 08/01/2021
updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 33 of 37
BNF Chapter 12 – Ear, Nose and Oropharynx
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 34 of 37
BNF Chapter 13 – Skin
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
Fludroxycortide 0.0125% cream
No date available Fludroxycortide 4micrograms/cm2 tape remains available 08/01/2021 Reviewed
Mupirocin (Bactroban) 2% cream
Resolved
08/01/2021 updated
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 35 of 37
BNF Chapter 14 – Immunological products and vaccines
Information on any issues relating to vaccines is available at: https://www.hps.scot.nhs.uk/publications/scottish-vaccine-update/
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
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BNF Chapter 15 – Anaesthesia
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
SUPPLY ISSUES INFORMATION | NHS FORTH VALLEY Last Updated: 15/01/2021
Page 37 of 37
Other
Product Current Supply Problem /
Date of Resolution Impact and Advice
Date Information Last Checked
