The products will no longer be in supply from April next year, “due to restrictions on permitted pricing” that mean the manufacture and supply of the tablets is “no longer viable”, Essential Pharma told C+D earlier this week (August 19).

“We have sought to minimise disruption to patients and to allow time for the transfer to suitable alternative lithium products by providing the Department of Health [and Social Care] (DH) with an extended notice period of such discontinuance,” it added.

The DH and the Royal College of Psychiatrists are producing “relevant guidelines for healthcare professionals and patients to aid such transition”, Essential Pharma said.

It added that it will “ensure that sufficient supply of Priadel” is available until April 6 next year, “to match local demand for the product until such date”.

Available alternatives

“Other brands of lithium carbonate tablets remain available, including Liskonum 450mg modified-release tablets, Camcolit 400mg modified-release tablets and lithium carbonate Essential Pharma 250mg tablets,” according to a DH supply disruption alert published today (August 21).

The DH is currently working with lithium manufacturers to ensure there is sufficient supply of alternative brands to enable the switching of patients.

Patients who are switched to a different lithium brand should be “encouraged to return any unused Priadel modified-release tablets to their community pharmacy for safe disposal and to avoid confusion”, the DH said in the alert.

“Lithium is indicated for the treatment and prophylaxis of mania, bipolar disorder, recurrent depression and the treatment of aggressive or self-harming behaviour,” the DH added, suggesting that “sudden discontinuation of lithium is associated with relapse in up to 50% of patients,” which could translate into mania.

Prescribers should make "individualised management plans" for certain patients who are being switched to an alternative lithium formulation, the DH said in the alert.

A DH spokesperson told C+D yesterday (August 20) that “alternative lithium products will remain available”.

“We understand the importance of carefully managing any changes to a patient’s treatment and are working with national mental health experts to produce guidance for healthcare professionals to support those affected,” they added.