The Department of Health and Social Care (DH) and NHS England (NHSE) last week (July 29) issued a national patient safety alert to all “appropriate prescribers” warning that there is a shortage of multiple antimicrobial medicines used to treat TB.
The alert stated that these medicines will be “intermittently available until at least the end of 2025”, adding that patients with TB should be “prioritised for remaining supplies of anti-TB oral medicines”.
According to the DH and NHSE, “the supply disruption is caused by a combination of factors”.
Read more: Drug shortages ‘unsustainable burden’ on pharmacy, MPs warn
The alert set out that the affected drugs are:
- Rifampicin 150mg and 300mg capsules
- Rifampicin 600mg IV solution for infusion
- Rifampicin 100mg/5ml oral suspension
- Rifinah 300 tablets (rifampicin 300mg / isoniazid 150mg)
- Rifater tablets (rifampicin 120mg / isoniazid 50mg/ pyrazinamide 300mg)
- Voractiv tablets (rifampicin 150mg/ isoniazid 75mg / pyrazinamide 400mg / ethambutol 275mg)
- Pyrazinamide 500mg tablets
“Amend prescriptions”
It explained that other TB treatments – Ethambutol tablets, Isoniazid tablets, Rifinah150 tablets and Mycobutin 150mg capsules – “remain available but cannot support a full increase in demand”.
Prescribers, such as community pharmacists, have been ordered to “amend prescriptions when the usual [or] preferred product is unavailable to avoid delays or interruptions in treatment”, it said.
They should also “limit prescriptions of affected oral anti-TB medicines to a maximum of one month’s supply to conserve stock”, it added, noting that these actions should be completed by August 15 and remain in place until supply issues are resolved.
Read more: DH: ‘No plans’ to review meds shortage impact on pharmacies
Pharmacists are also asked to “ensure patients are informed about changes to their usual or expected medication”, the alert said.
It noted that the multinational pharmaceutical company Sanofi is in agreement with NHSE to manage “available stock” by “allocating supplies and checking valid prescriptions” before releasing the medicine to “ensure fair distribution”.
“Limited quantities of unlicensed imports of anti-TB medicines can be sourced,” it said, adding that the Specialist Pharmacy Service and Regional Pharmacy Procurement Specialists are “working closely” with NHSE to “coordinate and streamline” this access.
Read more: Cancer patients ‘skipping meals’ amid ‘worst ever’ stock shortage
It comes as the pharmacy all-party parliamentary group (APPG) last month called for “immediate and coordinated action” following its findings that 84% of pharmacists encounter “daily” drug shortages, placing an “unsustainable burden on community pharmacy teams”.
And the National Pharmacy Association (NPA) revealed in June that 96% of members have experienced “challenges supplying” cancer drug Creon, with some calling it “the ‘worst stock shortage’ they have ever had to deal with”.
Meanwhile, the DH announced in May that it will consult on granting pharmacists “the flexibility to supply” drug alternatives in “cases of immediate clinical need” after a toddler died during antibiotic shortages.
