Manufacturing issues affecting the supply of the antidepressant fluoxetine mean that some strengths may not be available until December 2019, the Department of Health and Social Care (DHSC) has warned.
The supply issues affect fluoxetine 10mg capsules (Morningside Pharmaceuticals and Advanz Pharma), 30mg (Advanz Pharma) and 40mg (Advanz Pharma) capsules.
It is predicted that stocks of 10mg Advanz Pharma capsules will not be available until early December 2019, and that the 30mg and 40mg capsules will not be available until early November 2019.
The 10mg Morningside Pharmaceuticals capsules will not be available until the end of October 2019.
In a warning letter, the DHSC recommended that prescribers should identify all patients currently taking these strengths of fluoxetine and make early contact with either them or their carers to determine if their stocks will last until early November 2019.
For patients who have sufficient stocks, no repeat prescription should be issued during this period.
Prescribers should consider alternative preparations and/or strengths for patients who do not have sufficient supplies for the duration of the out-of-stock period. For example, suggested alternatives for fluoxetine 10mg capsules include fluoxetine 10mg tablets, fluoxetine 20mg/5ml oral solution, or unlicensed fluoxetine 10mg capsules.
The DHSC said it had identified specialist importers that can source unlicensed imports, but it warned that any decision to prescribe an unlicensed medicine must consider the relevant guidance and NHS trust or local governance procedures.
The Pharmaceutical Services Negotiating Committee has advised that if a pharmacist is asked to dispense an unlicensed import, the prescription should be annotated ‘special order’ (SP) and be endorsed with the quantity dispensed; pack size; price per pack; manufacturer license number; batch number; and specials procurement fee endorsement of ‘SP’.
- This article was amended on 30 September 2019 to replace the incorrect usage of the word ‘dose’ with ‘strength’