Medication updates

Piracetam (Nootropil) oral solution and tablets - various strengths

UCB Pharma have informed us that their Piracetam (Nootropil) oral solution has been discontinued, so stock levels are very depleted. If you are affected by this, please contact your GP who will be able to discuss your treatment plan.

They have also advised that the production date of Nootropil tablets (800mg and 1200mg) was moved to 20 November, which has led to some temporary local shortages. Stock levels should now start to recover in local wholesaler branches. If you experience local shortages of tablets, UCB advise that you should ask your pharmacy to contact Alliance Healthcare, as they will be able to send new stock to local branches where required.

Epistatus (Midazolam) 2.5mg/0.25mL oromucosal solution pre-filled oral syringes

Veriton Pharma has informed us that their Epistatus (Midazolam) 2.5mg/0/25mL oromucosal solution pre-filled oral syringes are out of stock until early 2024 due to a manufacturer issue. There are no supply issues with other strengths of Epistatus.

If you are experiencing supply issues, please consult your GP who will be able to discuss your treatment plan.

Lamotrigine Accord tablets - supply issues with some strengths

Accord Healthcare have updated us on the supply of some strengths of their Lamotrigine tablets:

• 25mg tablets - currently only available via Mawdsleys wholesalers.
• 50mg tablets - stock will be available very shortly.
• 100mg tablets - no current supply issues.
• 200mg tablets - stock available from the start of November.

If you are experiencing supply issues, please consult your GP who will be able to discuss your treatment plan.

Tegretol (carbamazepine) - 100mg supply issue

We have been informed by the global healthcare company, Novartis, that there is currently a supply issue with Tegretol (carbamazepine) 100mg tablets. All other Tegretol lines are available.

Carbamazepine is a category 1 anti-seizure medication according to MHRA guidance for prescribing drugs. This means that people should not be switched between versions of this medication but should be kept on the same type. 

If you are experiencing supply issues, please consult your GP who will be able to discuss your treatment plan. 

Oxcarbazepine (Trileptal®) - supply shortage

UPDATE 2 August 2023

Novartis says they are now able to supply both Oxcarbazepine (Trileptal®) 300mg and 600mg tablets. If anyone is experiencing supply issues, they should ask their pharmacist to call Novartis Customer Care team on 0845 741 9442. This information relates to England, Scotland and Wales. Anyone in Northern Ireland who is experiencing should call the customer care team for further details.

UPDATE 31 July 2023

Novartis has informed us that there are still supply issues with Oxcarbazepine (Trileptal®) 300mg tablets. However, all other variations are now available. If you are experiencing problems, please contact  Customer Care Co-ordinator at Novartis Pharmaceuticals UK Limited by emailing Tyrone.dean-morris@novartis.com, 01276 692255 www.novartis.com

Original post 23 June 2023

The Department of Health has warned that there will be supply issues with some dosages of oxcarbazepine (Trileptal®) until mid-July. The following dosages will be affected:

• Oxcarbazepine (Trileptal®) 300mg tablets will be out of stock from late June to mid-July 2023
• Oxcarbazepine (Trileptal®) 600mg tablets are out of stock now and will remain so until mid-July 2023.

Generic versions of both 300mg and 600mg oxcarbazepine tablets are available and are expected to meet increased demand.

Oxcarbazepine (Trileptal®) 150mg tablets and generic oxcarbazepine 150g tablets are also available but will not be able to support the increase in demand. Oxcarbazepine (Trileptal®) 60mg/ml oral suspension also remains available but will not be able to meet an increase in demand.

Advice to people taking Trileptal®

If you are taking Trileptal®, please seek the advice of your doctor or epilepsy specialist. If you have to switch to a different version of your medication, discuss any potential side effects with your doctor and make sure you inform them of any change in seizure control.

Advice for doctors

Doctors are being advised to identify people with epilepsy who are taking Trileptal®, and to prioritise them for any remaining stock. If the tablets are not available and the person has to be switched to a  generic version of the medication, they should be carefully monitored for adverse effects and a change in seizure control. People should be reassured that they are still taking the same drug at the same dosage but should report any side effects.

If switching to a generic version of the medication is not considered appropriate, advice should be sort from a specialist.

No new patients should be started on Trileptal until the shortage has been resolved.

RECALL Sabril 500 mg film-coated tablets & Sabril 500 mg granules for oral solution

The MHRA has issued a recall affecting some patients using Sabril tablets and Sabril granules (vigabatrin). This has been issued as a precautionary measure due to the detection of traces of tiapride in the batches of the source material of manufacturer for vigabatrin.

Sabril (vigabatrin) is indicated for adjunctive treatment of focal seizures with or without secondary generalisation not satisfactorily controlled with other antiepileptics (under expert supervision) and monotherapy in the treatment of infantile spasms (West's syndrome). 
 
All patients should be advised not to discontinue Sabril tablets or Sabril granules without consulting with their prescriber. The risks of suddenly stopping medication for seizures/epilepsy is higher than the potential risk presented by the presence of tiapride. Sanofi UK have confirmed that no other batches are impacted, and other stock remains available

Vigabatrin (Sabril) 500mg tablets supply shortage

Sanofi has told us it is experiencing a shortage of vigabatrin (Sabril) 500 mg film-coated tablets in the UK and anticipate that this medicine will go out of stock at the end of June.

The shortage is due to a delay in the global supply of the active pharmaceutical ingredient used to manufacture vigabatrin. The company is working to resolve the issue and hopes that the medication will be back in stock by mid-July 2023.

In a statement, Sanofi said: “We sincerely apologise for any inconvenience and difficulty for patients and healthcare professionals that this supply shortage may cause. We are in constant communication with the UK Department of Health and Social Care (DHSC) to try to minimise the disruption for patients.”

Advice to people with epilepsy

If anyone taking the medication has concerns, they should contact their healthcare professional regarding treatment. Clinicians can contact Sanofi’s Medical Information Service for further information via email on uk-medicalinformation@sanofi.com or by telephone on +44 (0) 800 035 2525.

Any pharmacists who have enquiries relating to stock can contact Sanofi Customer Services on +44 (0)800 854 430. 

Adverse events should be reported. Reporting forms and information can be found at MHRA Yellow Card or search 'yellow card' in the Google Play or Apple App Store. Adverse events should also be reported to the Sanofi drug safety department on Tel: 0800 0902 314. Alternatively, send via email to uk-drugsafety@sanofi.com
 

Supply of Frisium (clobazam) now restored

We have been informed by Sanofi that there is now a full supply of Frisium (clobazam) available in the UK.

There had been a delay in the renewal of the pharmaceutical company’s Controlled Drugs Licence but this has now been resolved and the medication is once again available to pharmacies.

Sanofi issued the following statement: 
“Sanofi currently has full supply of Frisium (clobazam) available in the UK (GB/NI).

Following an expedited review and renewal of our Controlled Drugs Licence by the UK Home Office, we are now able to make this medicine available to pharmacies. 

We regret any impact that the delay may have had on patients and healthcare professionals.

Should patients have issues obtaining supply from their pharmacist, the pharmacist can contact Sanofi Customer Services (+44 (0)800 854 430) for support.  

Should patients have any concerns about their treatment, they should speak to their clinician about treatment options.”

Oxcarbazepine Tabs Mylan 150Mg supply issue

There is currently a supply issue with Oxcarbazepine Tabs Mylan 150Mg X 50. Re-supply is expected in mid-June.

Mylan have informed us that both Oxcarbazepine Tabs 300Mg X 50 and 600Mg X 50 are available.

If pharmacies are experiencing problems with supply from their wholesaler, they should contact Mylan’s medical information department on 01707 853 000 and select option 1.

If you have concerns about your medication, always consult your doctor before your supply runs out. For emotional support, please call our Helpline on 01494 601400.
 

Shortage of Accord-Healthcare levetiracetam 250mg and 1000mg

We have been informed by Accord-Healthcare  that they are currently out of stock of 250mg and 1000mg levetiracetam. They do, however, have the 500mg and 750mg doses.

There are other versions of levetiracetam available. If you have any issues with your prescription, please contact your GP.

For more information  contact Accord-Healthcare's Medical Information team on 01271 385257 or visit www.accord-healthcare.co.uk
 

Frisium (clobazam) and Zimovane (zopiclone) supply issue

We have been informed by the pharmaceutical company, Sanofi, that they are currently unable to supply Frisium (clobazam) or Zimovane (zopiclone) in the UK.

Both theses medications require a Controlled Drugs Licence which is granted by the Home Office. There has been a delay in the renewal of Sanofi’s Controlled Drugs Licence for these two medicines. This is currently being reviewed by the UK Home Office.

This means that neither medication is available and anyone who is prescribed the drugs should consult their doctor about changing to another form of clobazam. 

Switching between versions of medication

Clobazam is classed as a category two drug under guidance from the medicines regulator, the MHRA. Anyone prescribed drugs in this category should only change to another version of the same drug after consultation with their doctor.

The following generic versions of clobazam are also available: Perizam, Tapclob and Zacco.

Statement from Sanofi

Sanofi are working to resolve the situation and are hoping that the Home Office will accelerate the renewal review process. The pharmaceutical company have issued the following statement: 

“We are currently unable to supply Frisium (clobazam) or Zimovane (zopiclone) in the UK (GB/NI).

These medicines require a Controlled Drugs Licence which is granted by the UK Home Office. There has been a delay in the renewal of Sanofi’s Controlled Drugs Licence for these two medicines. The UK Home Office is currently reviewing the licence renewal.

We regret the situation and any impact the delay may have on patients and healthcare professionals.

We are doing everything we can to seek an expedited licence renewal review process, and are in constant communication with the UK Home Office and the Department of Health and Social Care (DHSC) to find a solution that enables patient access to these medicines as soon as possible. We are also keeping the Medicines and Healthcare products Regulatory Agency (MHRA) informed of the renewal progress.

At this stage, we cannot confirm when the licence review process will be completed by the UK Home Office and Sanofi will be able to return to normal supply of these medicines. However as soon as we have an update this will be communicated with the healthcare community.

Where Frisium (clobazam) and/or Zimovane (zopiclone) are not available, patients are advised to refer to their treating doctor who may suggest an appropriate alternative treatment. The choice of alternative treatment should be made by the patient and healthcare professional together, considering the patient’s condition and the suitability of available alternatives. Patients and healthcare professionals can contact Sanofi Medical Information on uk-medicalinformation@sanofi.com or +44 (0) 800 035 2525.

Adverse events/Side effects should be reported. Reporting forms and information can be found atwww.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to the Sanofi drug safety department on 0800 0902 314. Alternatively, send via email to UK-drugsafety@sanofi.com.”
 

Sabril (vigabatrin) back in stock

Following recent supply issues, we have received the following statement from Sanofi assuring us that Sabril (vigabatrin) 500 mg film-coated tablets are now back in stock in the UK. There is currently a good level of supply for all formulations of Sabril in the UK and global issues are being resolved to protect long-term supplies.

“Following recent supply issues, Sanofi can confirm that Sabril (vigabatrin) 500 mg film-coated tablets are now back in stock in the UK. 

The recent shortage of Sabril (vigabatrin) medicines was initially the result of a delay in the global supply of the active pharmaceutical ingredient (API) used to manufacture vigabatrin from our current supplier. Sanofi has since contracted a second supplier of API to try to alleviate this issue and address delays in global production.  Continuing issues relating to API have affected a planned resupply to the UK in early 2023, and Sanofi is working globally on a long-term solution to these issues.

We sincerely apologise for the inconvenience and difficulty for patients and healthcare professionals that this supply shortage has caused. Sanofi has done everything it can to supply as soon as possible and is in constant communication with the UK Department of Health and Social Care (DHSC) to try to minimise any disruption for patients. 

Should patients have any issues obtaining supply from their pharmacist, the pharmacist can contact Sanofi Customer Services (+44 (0)800 854 430)) for support.

If patients have concerns about treatment, they should contact their healthcare professional regarding treatment. Clinicians can contact Sanofi’s Medical Information Service for further information via email on uk-medicalinformation@sanofi.com or by telephone on +44 (0)800 035 25 25.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to the Sanofi drug safety department on Tel: 0800 0902 314. Alternatively, send via email to UK@drugsafety@sanofi.com.”
 

Lamotrigine (Lamictal) shortage

We have been informed by GSK that lamotrigine (Lamictal 2mg and 5mg Dispersible) is temporarily out of stock in the UK. GSK have told us that they expect them to be back in stock, with an estimated delivery in late February 2023.

If you have any concerns about getting your usual medicine, please speak to your pharmacist or GP for advice.

You can get in touch with GSK Customer Support team via email for further information. For UK Pharma Customer Support: customercontactuk@gsk.com and UK Consumer Healthcare enquiries: customer.relationships@gsk.com

Switching between different brands of medication

It is important to have a consistent supply of your epilepsy medication. If the supply issue means you have to switch to a different version of lamotrigine, make sure this is with supervision from your doctor.

The updated advice by MHRA on switching between different manufacturers’ products can be read here : Antiepileptic drugs: updated advice on switching between different manufacturers’ products - GOV.UK (www.gov.uk)

Topiramate (Topamax) shortage

We have been advised by Janssen that there is currently a shortage of topiramate (Topamax) in the UK. Supply of this medication is usually made available through wholesalers, Alliance & Phoenix Healthcare.

Pharmacies experiencing issues in obtaining supply of topiramate should contact Janssen Customer Services on 01494 567 400 or by emailing JanssenUKCustomerServices@its.jnj.com

They can arrange for an emergency order form to be sent to the pharmacy for them to complete and return with a copy of the redacted prescription.

Janssen will then arrange a direct delivery to the pharmacy within 1-2 working days at no additional cost.

Safety review

In July 2022, the MHRA launched a safety review into topiramate. Read further details here.
It is important to never stop taking your medication without the supervision of a healthcare professional.
 

Epanutin (phenytoin) 30mg/5ml oral suspension supply issue

We have been informed by the Department of Health that there is a short-term supply issue with Epanutin (phenytoin) 30mg/5ml 500ml oral suspension.

The Department’s Medicines Supply Team has been working closely with Viatris, suppliers of Epanutin, to minimise any disruption for patients.

The next delivery in the UK is expected by the middle of next week. To ensure that existing supplies last until then, Viatris have implemented a system of prescription validation in primary care from today.

This means, that before dispensing a prescription for Epanutin oral suspension, the pharmacist must first validate the prescription with the wholesaler, Alliance. Once validated, Alliance will then release the medication direct to the pharmacy by the next day.

The patient may need to return to the pharmacy the following day to pick up their prescription.

Viatris took over supply of Epanutin (phenytoin) 30mg/5ml 500ml oral suspension from Pfizer in late 2021.
 

Epilim Chrono modified release - some local issues

We are aware that some people have experienced difficulties in accessing the following epilepsy medication:

•    Epilim Chrono modified release 200mg

The pharmaceutical company Sanofi has assured us that they have stock nationally, but there have been regional supply issues in some areas.
Anyone experiencing a problem should ask their pharmacist to contact Sanofi Customer Service line on 0800854430 who will be able to help.

Vimpat and Vimpat Liquid - no shortage but delivery issues

We are aware that some people have experienced difficulties in accessing the following epilepsy medication:

•    Vimpat 50mg
•    Vimpat liquid

The pharmaceutical company UCB has assured us that there are no supply issues, though there have been delivery issues in some areas resulting in local shortages.

If you experience a problem getting your prescription of Vimpat, please contact UCB Cares on
0800 2793177, email UCBCares.UK@ucb.com or visit https://www.ucbcares.co.uk