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To curb the supply issue of HRT medicine, the government has taken a further action by issuing SSPs for Oestrogel, Ovestin cream, Lenzetto transdermal spray and Sandrena gel sachets - with appropriate alternatives. The move aims to allow community pharmacists to supply specified alternatives to the prescribed HRT products without needing to seek authorisation from the clinician who has prescribed the medicine. The regulator said that the availability of Premique Low Dose has impoved 'thanks to SSPs issued on 29 April to restrict dispensing for Oestrogel, Ovestin and Premique Low Dose to three months' supply'. "Since these measures were implemented, further deliveries of all three products have been made, with Premique Low Dose returning to good availability this week. The manufacturers of Oestrogel and Ovestin, as well as suppliers of alternative HRT products, are taking action to increase UK supply." It added, "SSPs restricting prescriptions to a maximum of three months' supply will also be issued for substitute products, as a precautionary measure to ensure the supply of those substitutes is maintained."

The Department of Health and Social Care (DHSC) has allowed pharmacists to supply alternative penicillin to treat Strep A. It has issued Serious Shortage Protocols (SSPs) for three penicillin medicines. "The SSPs will help mitigate local supply issues of oral penicillin and allow pharmacists to supply alternative forms of the medicine if they do not have the specific formulation stated on the prescription," said DHSC. SSPs have been issued across the UK for 3 penicillin medicines on Thursday (December 15. "Issuing an SSP allows pharmacists to legally supply a specified alternative medicine, removing the need for the patient to return to the prescriber - which saves time in GP practices and inconvenience for patients." "Demand for penicillin has risen recently as it is used to treat strep A and scarlet fever, and the increased demand means that some pharmacists are experiencing temporary and localised supply issues and may not have the specific formulation listed on the prescription."

Three batches of Mexiletine hydrochloride 50mg, 100mg and 200 mg hard capsules manufactured by Clinigen Healthcare has been recalled. Pharmacists are urged to quarantine the said batches and return it to the supplier by or before 12 August. Clinigen Healthcare Ltd has initiated a recall of three batches of Mexiletine hydrochloride hard capsules due to a potential risk of under dose or overdose, which could have consequences for the safety of patients. The manufacturer has confirmed that no alternative batches of Mexiletine hydrochloride 50mg, 100mg or 200mg hard capsules will be available until later in the year, therefore the recall of these batches from patients should only be considered where patients have access to appropriate alternative products. See below for more information on resupplying patients with alternative products. "Patients should be advised not to stop any treatments without consulting their relevant healthcare professional. The risks of suddenly stopping medication for ventricular arrhythmias is higher than the potential risk presented by too much or too little of the active ingredient in the capsule."

There has been extensive national media coverage today (August 11) on how medicine shortages have forced patients to visit multiple pharmacies to get their prescriptions filled or return to their GP to be prescribed alternative drugs. These media reports have been based on a survey involving more than 1,500 pharmacists in the UK, in which over a half of those polled said that their patients' health had been put at risk in the last six months. In response to a query from Pharmacy Business, the Department of Health and Social Care (DHSC) said it monitors the medicines supply chain closely to prevent any shortages and acts swiftly when any issue arises. A DHSC spokesperson told Pharmacy Business: "We take patient safety extremely seriously and we routinely share information about medicine supply issues directly with the NHS so they can put plans in place to reduce the risk of any shortage impacting patients, including offering alternative medication.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Dioralyte oral rehydration sachets. "Dioralyte oral rehydration sachets are expected to be in limited supply until late December 2022. St Mark's solution is available as an unlicensed special and can support an uplift in demand," said DHSC. "Kidderminster formula is available as an unlicensed special and can support a partial uplift in demand. As an alternative to the unlicensed specials, the individual components can be purchased from community pharmacies and supermarkets or prescribed, but there have been intermittent supply issues with glucose powder." Diluted apple juice has been reported to be a potential alternative to electrolyte maintenance fluids in children with mild gastroenteritis and minimal dehydration. If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed St Mark's solution cannot be issued.

The Pharmacists' Defence Association (PDA) has announced that it will support its member impacted by the decision to close 300 more Boots pharmacies. After the announcement of closure of 300 Boots pharmacies over the next year, the association believes this is approximately one out of every eight current Boots pharmacy locations. The company has insisted that the objective of this exercise is not to make existing pharmacist employees redundant, and they hope to be able to redeploy individuals into nearby alternative locations. However, PDA believes that it is unlikely that suitable alternative roles will be available for all and redundancy is a possibility for some. The PDA Union will provide pharmacists with information, support, and representation as part of the recognition agreement so that members are aware of and can exercise their rights at work. PDA officials will be in continued dialogue with the company throughout this closure programme.

The Department of Health and Social Care (DHSC) has suggested Estradiol patch as an alternative for patients who use 1 pump of Oestrogel daily. DHSC has updated Annex A of SSP022 and SSP023 for Oestrogel Pump-Pack 0.06 per cent gel to include a dose conversion to a specific alternative Estradiol patch. Previously, only dose conversions for patients using 2 to 4 pumps daily were included in Annex A of SSP022 and SSP023. Separately, the supporting guidance for three SSPs which allow quantity restriction have been updated to reflect the requirement to endorse the reduced quantity supplied in accordance with these SSPs. SSP019 - Oestrogel pump-pack 0.06% gel SSP020 - Ovestin 1mg cream SSP021 - Premique low dose 0.3mg/1.5mg modified release tablets "When endorsing an SSP for a reduced quantity, contractors must ensure that the correct SSP number is endorsed along with the product name and the reduced quantity supplied in accordance with the SSP," said PSNC.

Cutting the red tape that blocks pharmacists to alter the HRT prescription could 'quickly fix' the problem of women unable to access their HRT medicines, the Royal Pharmaceutical Society (RPS) told Daily Mail. RPS has suggested that allowing pharmacists to prescribe alternative HRT treatment amid nationwide shortage of HRT medicine could help the women who are struggling to access these medicines. Thorrun Govind, chair of the English Pharmacy Board, told MailOnline 'changes in prescription rules need to be changed urgently.' She added, 'For the pharmacists on the ground, they need the ability to get rid of this bureaucracy. When you think about it - who's best able to offer an alternative - that tends to be the pharmacist.' MailOnline quoted Professor Claire Anderson, president of the Royal Pharmaceutical Society, as said, 'We welcome the Health Secretary meeting with key suppliers and manufacturers to find solutions to the current shortages. But cutting the red tape holding pharmacists back could provide a 'quick fix' that would allow 'women to access their HRT medicines more speedily'.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for antibiotics for the treatment of Group A Strep. "Supplies of antibiotics for the treatment of Group A Strep have seen a surge in demand and may be temporarily in limited supply at certain wholesalers and pharmacies," said DHSC. "Supplies are available with manufacturers, and deliveries into wholesalers and pharmacies are being expedited and are expected in the coming days." If the formulation of antibiotic prescribed is unavailable, DHSC has asked clinicians and local pharmacy teams to consider prescribing an alternative form or strength of the antibiotic where appropriate, ensuring the patient is not intolerant to any of the excipients in the alternative and is counselled on the appropriate dose (and volume) required.

The Department of Health and Social Care (DHSC) has issued a medicine supply notification for Sulfasalazine 250mg in 5ml oral suspension sugar free; Pilocarpine hydrochloride 4% eye drops; Fluticasone 50microgram / Salmeterol 25microgam (Combisal) pressurised metered dose inhaler (pMDI); and Dalteparin (Fragmin) 10,000units/1mL solution for injection ampoule on Wednesday (21 December). "Sulfasalazine 250mg/5ml oral suspension sugar free is out of stock from w/c 19th December until early June 2023. Sulfasalazine 500mg non-enteric coated tablets remain available "IPS Pharma, Nova Labs, and Rokshaw have currently confirmed they can manufacturer sulfasalazine 250mg/5ml oral suspension," said DHSC. Pilocarpine 4% eye drops are out of stock until w/c 26th December 2022. Alternative strengths of pilocarpine (1% and 2%) eye drops remain available and will be able to support increased demand. Specials of pilocarpine 4% preservative free eye drops are available if the licensed alternatives are not suitable. For off-label use of the 4% drops in the treatment of xerostomia (dry mouth) in palliative care, pilocarpine 5mg tablets are available and are licensed for this indication.

Aspire Pharma Limited has solidified its position as a leading specialty generics enterprise by adding leuprorelin acetate as a branded generic to its oncology portfolio. Leuprorelin acetate is hormone therapy recommended for patients with high-risk localised, locally advanced, and metastatic prostate cancer, serving as an alternative to surgical castration for locally advanced cases. Used as an alternative to surgical castration for locally advanced prostate cancer, a pre-filled syringe containing 11.25mg of leuprorelin acetate (equivalent to 10.72 mg leuprorelin) is injected subcutaneously into the abdomen. The British pharmaceutical company noted that one of its primary objectives is to seek "new investment opportunities" that brings products and companies into its portfolio, aligning closely with Aspire values and therapeutic focus areas. Prostate cancer is the most common cancer among men in the UK, with an average of over 52,000 men receiving a diagnosis of prostate cancer annually, as per Prostate Cancer UK.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for Clomifene (Clomid) 50mg tablets on Monday (5 June). It said: "Sanofi will be out of stock of clomifene (Clomid) 50mg tablets from w/c 12 June 2023 until w/c 18 September 2023." "Generic clomifene 50mg tablets remain available from Wockhardt who are able to partially uplift supplies until the end of July 2023. Unlicensed supplies of clomifene 50mg tablets may be sourced, lead times vary. Alternative medicines for use in infertility remain available," it added. The specialist importers- Orifam and Target Healthcare have confirmed to DHSC they can source unlicensed clomifene 50mg tablets. "If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed clomifene 50mg tablets cannot be issued," said Community Pharmacy England.

At the Conservative Party Conference, PM Rishi Sunak pledged to raise the legal age every year to buy from those who were born in 2009. The proposed changes also encompass heated tobacco products, recognized as smoke-free alternatives that heat, not burn, tobacco to produce a distinct nicotine-containing aerosol compared to traditional cigarette smoke. The following move in a bid to "try and stop teenagers taking up cigarettes in the first place", and bring in restrictions to stop young people from vaping. PM Rishi Sunak spoke at the conference, "Last week I promised to create the first smoke-free generation and I am wasting no time to deliver on that promise.

A recent report by the British Generic Manufacturers Association (BGMA) has shed light on ongoing supply challenges in England's generic medicines market, revealing significant issues impacting patient care. The report highlights significant challenges faced in supply of medicines as currently, 51.72 per cent of generics in short supply lack licensed alternatives, posing substantial hurdles to ensuring continuous patient care. Additionally, 39.08 per cent of affected generics are branded, indicating widespread disruptions across the market. A notable 26.44 per cent of generics experiencing shortages have been affected for over six months, highlighting persistent difficulties in supply chain management. The report indicates that 0.15 per cent of generic medicine presentations listed in the Drug Tariff are currently facing supply issues, impacting accessibility nationwide.

With the increasing stress environment infertility has been steadily increasing in Gurgaon. In a recent survey 15 out of every 100 couples in urban India are opting for Alternate Reproductive Procedure (ARP). However choosing the right IVF Specialist can be a daunting task for the couples. Generally it is seen that Gurgaon couples start consulting for gynaecologists in South Delhi as south delhi has better quality of gynae doctors and facility. However it should be kept in mind that IVF is a complex and lengthy process so one should go for experts in IVF and not general gynaecologist and that too in Gurgaon. https://explorehealthnews.blogspot.com/2017/07/how-to-choose-right-ivf-specialist.html

Medical abortion is a way to end a pregnancy by using abortion-inducing medications as an alternative to surgical abortion methods. This procedure is administered up to 7 - 9 weeks after the first day of the last menstrual period. This blog is a detailed discussion on ideal usage, mechanism of action, dosage and how to purchase abortion from the authorized online pharmacy...

A daily medication for high blood pressure could be replaced by an injection twice a year, if Queen Mary University and Barts Health NHS Trust succeed in their trail to investigate if an injection-based drug - Zilebesiran - could inhibit the production of a protein called angiotensinogen (AGT). Scientists are to trial a world-first drug to treat high blood pressure that can be given by injection twice a year. Professor Sir Nilesh Samani, medical director, British Heart Foundation, said: "This exciting trial could lead to good news for the millions of people across the UK with high blood pressure, many of whom need to take daily medication to lower their risk of heart attacks and strokes. "The study will determine whether an injection given twice a year lowers blood pressure sufficiently over a prolonged period. "If this proves to be the case, it may provide an alternative to taking daily pills for some patients."

The Department of Health and Social Care has issued a Serious Shortage Protocol (SSP) in response to a significant ongoing disruption to the supply of Paracetamol 120mg and 240mg suppositories. Effective from Tuesday (Jan 25), SSP015 provides that for every Paracetamol 120mg or 240mg suppository originally prescribed, one Paracetamol 125mg or 250mg suppository must be supplied. SSP015, authorised by the Secretary of State, has been developed by clinicians and provides pharmacists with procedures to follow in providing either of these suitable alternative products to help reduce the number of patients having to return to their prescriber for a replacement prescription. The SSP may be amended or revoked at any time but currently expires on 18 February 2022 - PSNC will update contractors on any changes.

Amendments to the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013 along with introduction of a new type of pharmaceutical service come into effect from Tuesday (December 21) and from January 1, 2022. PSNC will be consulted on the new type of enhanced service - the National Enhanced Service (NES), where NHS England and NHS Improvement (NHSE&I) commissions an enhanced service with a service specification that sets standard conditions nationally. Other amendments to the regulations include: Changes in the contractors' terms of service, allowing NHSE&I to introduce a pandemic response programme, by which contractors are required to have various premises and other arrangements for responding to a pandemic. An alternative route to supply pandemic treatments, via a listed prescription items voucher (LPIV). This is a further option for the community pharmacy for supply of treatments or medicines during or in anticipation of pandemic disease;

Hypovase (prazosin) 500 microgram tablets, manufactured by drug major Pfizer, will remain out of stock until mid-January 2022 due to a manufacturing issue. The Department of Health and Social Care (DHSC) and NHS England and Improvement (NHSE&I) have issued a supply disruption alert for the medicine that is used to treat heart-related troubles. Pfizer, the sole supplier of prazosin 500mg tablets in the UK, is out of stock from late November 2021, and had discontinued the Hypovase® (prazosin) 1mg tablets in May 2021. Advice for healthcare professionals In the given situation, prescribers need to review all affected patients to discuss management plans. Meanwhile, alternative medicine alpha blockers remain available to support an uplift in demand.