Anti-epileptic shortages are ‘concerning’, patient support organisations say

Some dosages of an anti-epileptic drug are set to be “out of stock” in the UK until mid-July 2023, with other dosages and formulations insufficient to meet the shortfall, a Department of Health and Social Care notice has warned.

The medicine supply notification, published on 14 June 2023, said that the stock issues will affect oxcarbazepine (Trileptal; Novartis Pharmaceuticals) 300mg and 600mg tablets from “late June 2023”.

Some 7,516 items of Trileptal 300mg and 600mg tablets were dispensed in 2022/2023 according to data published by NHS Business Services Authority on 8 June 2023.

Alternative dosages (150mg tablets) and formulations (60mg/mL oral suspension) of Trileptal will be available “but cannot meet an increase in demand”, the notification said.

It added that prescribers should identify patients taking the affected tablets “and prioritise this group of patients for any remaining stock when issuing prescriptions, liaising with community pharmacy to establish availability”.

Generic oxcarbazepine 300mg and 600mg tablets will remain available for patients, which the DHSC said could meet increased demand.

However, David Thornton, advice team leader at Epilepsy Action, said: “It’s concerning to see that multiple formulations of Trileptal have been unavailable, oral suspension being one of these. Many people rely on Trileptal oral suspension with no generic alternative oral suspension.

“We’re also concerned that 300mg and 600mg Trileptal tablets are out of stock and 150mg tablets can’t support an increased demand.

“Oxcarbazepine is a category 2 medicine, so for many people it will have been decided by them and their doctor that they should stay on Trileptal where possible.

“If anyone has concerns about supply of their medicine or taking a different version, they can speak to their doctor or pharmacist for advice. While not ideal, for most people it’s safer to take a different version of their medicine than to run out and stop taking medicine completely.”

On 1 June 2023, The Pharmaceutical Journal‘s 2023 salary and job satisfaction survey of more than 1,500 UK pharmacists revealed that 57% of respondents thought that shortages have put their patients at risk in the past six months, despite government efforts to try and mitigate problems.

Of 1,578 (57%) pharmacists working in all sectors of the profession, 902 answered ‘Yes’ when asked if medicines shortages have put patients at risk “in the past six months”.

The DHSC has attempted to mitigate the impact of shortages on patients. In the year to May 2023, it issued 23 serious shortage protocols for medicines facing supply problems.

However, The Pharmaceutical Journal’s survey also revealed, despite these measures, 15% of respondents are spending more than five hours per week on activities related to shortages, while 33% are still unable to supply prescribed medicines to more than ten patients per week owing to shortages.