16th October - Ranitidine supply issue 

• All oral formulations of ranitidine are anticipated to be out of stock, with no date for resupply until further notice.

• An investigation by the Swiss and German regulatory agencies and the US Food and Drug Administration (FDA), has identified a contaminant, N-nitrosodimethylamine (NDMA), in samples of ranitidine active substance.

• All stock manufactured for the UK using the affected ranitidine active substance has been quarantined, whilst Medicines and Healthcare products Regulatory Agency (MHRA) investigations are ongoing.
• Although all oral formulations are expected to be out of stock, very limited supplies of unaffected oral ranitidine products may remain available and should be reserved for those patients in whom alternatives are not clinically appropriate.
• All other patients should be reviewed as repeat prescriptions are requested, and if ongoing treatment is required, be switched to clinical alternatives.
• Please see the CAS alert for details about actions required and alternatives

14th October 2019 - Updates to shortages

Phenelzine now unavailable until March 2020 (see drug entry for details)

Adrenaline auto-injectors

• Emerade supplies expected w/c 14th October
• Reports of Emerade auto-injectors failing to activate, patients must carry two pens at all times
• Some batches of EpiPen and Jext have had their expiry dates extended - see epipen.co.uk and jext.co.uk for details
• Further details can be found here (N3 connection required)

11th October

Serious shortage protocols for fluoxetine

Serious shortage protocols are available for use with the fluoxetine capsule shortage see here.

UPDATE: Ranitidine products linked to impurity and carcinogen (NDMA).

Zantac – MHRA drug alert issued as GlaxoSmithKline recalls all unexpired pharmacy stock.

At present patients and healthcare professionals are advised to continue using their medicines as normal. The health risk of discontinuing the medicine is higher than the potential risk presented by the contaminant. Currently there is no evidence that medicines containing the impurity have caused any harm to patients but the MHRA is closely monitoring the situation. Patients do not need to see their Doctor until their next routine appointment, but should seek their doctor’s advice if they have any concerns.

An MHRA investigation into other brands of ranitidine medicines which may also be affected is continuing and further updates will be provided as this investigation progresses. Currently other ranitidine products have not been recalled.

Shortages update 30th September 2019

• Loestrin 20 and 30 have been discontinued by the manufacturer
• Noriday is now back in stock
• EpiPen Junior is now subject to prescription validation process

Shortage update 24th September 2019 - manufacturing delays

Both strengths of capsaicain cream will be out of stock until at least November 2019. For more information click here (commercially sensitive, N3 connection only)

Both strengths of mianserin are out of stock until the end of 2019. For more information click here (commercially sensitive, N3 connection only). 

All strengths of tiagabine will be out of stock until the end of October 2019. For more information click here (commercially sensitive, N3 connection only).