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The Medicine and Healthcare Product Regulatory Agency (MHRA) has recalled all pholcodine-containing medicines from the UK pharmacy due to concerns of its potential to cause a severe allergic reaction in some people having general anaesthesia for surgery. The decision was made following the conclusion of a review of post-marketing safety data by the MHRA. The Commission on Human Medicines (CHM) has considered the evidence of an increased risk of the very rare event of anaphylaxis when exposed to neuromuscular blocking agents (NMBA) and advised that pholcodine-containing medicines should be withdrawn. MHRA has advised pharmacists to consider recommending appropriate treatment alternatives for patients who present with a new dry cough or who are currently taking pholcodine. Royal Pharmaceutical Society (RPS) President Professor Claire Anderson said: "If you are taking a cough medicine (including tablets and syrups), check the packaging, label or Patient Information Leaflet to see if pholcodine is a listed ingredient - if it is, and you have any questions, you can talk to your pharmacist who can suggest a different medicine suitable for you.

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."

The Royal Pharmaceutical Society (RPS) has backed a new framework from NHS England to reduce inappropriate prescribing of addiction-causing medicines. It believes that the new framework is a positive step towards improving patient care by supporting medicine reviews and shared decision making to help people reduce their use of medicines that are no longer providing much clinical benefit. The society has also welcomed investment in innovative approaches to supporting patients and urged all pharmacists to refer people to such schemes. Director for England at RPS, James Davies said: "Pharmacists are well-placed to help reduce inappropriate prescribing of high strength painkillers such as opioids and other addictive medicines. "Pharmacy teams can also often spot repeat purchases of over the counter medicines by patients so are well placed to intervene and give advice on the management of chronic pain. Whilst opioids can play an important part in helping people with chronic pain there has long been a need for alternative approaches that are safer and more effective for patients.

Insuman Comb 50 100units/ml suspension for injection 3ml cartridges has been discontinued with stocks being exhausted imminently, notified Department of Health and Social Care (DHSC). The department has issued a medicine supply notification for Insulin isophane biphasic human 50/50 (Insuman Comb 50) 100units/ml suspension for injection 3ml cartridge. "Humolog Mix 50 remains available, as do other biphasic insulin preparations, and the manufacturers can support a full uplift in supply," said DHSC. A copy of this medicine supply notification, including further information, has been sent to all pharmacy NHS email addresses. DHSC and NHSE/I's newly launched online Medicines Supply Tool provides up to date information about medicine supply issues. The contents of these MSNs can now be viewed on the Tool.

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 government has launched a consultation into radically changing the Statutory Scheme for branded medicines (known as the Statutory Scheme). The consultation comes as delicate negotiations for replacing the alternative Voluntary Scheme are underway, potentially undermining these talks, while also further damaging industry confidence in the UK as a viable place to research, launch and supply medicine. The government proposals seek to hold average revenue clawback rates under the Statutory Scheme at historic highs of between 21-27%, compared to the pre-pandemic averages of 9.4% for the Statutory Scheme (2019-2021), and 6.88% for the Voluntary Scheme (2014-2021). The accompanying cost-benefit analysis ignores any negative impact this may have on medicine supply and wrongly claims it will boost investment. The consultation comes on the heels of government data last week showing UK life sciences foreign direct investment (FDI) fell by 47% between 2021 and 2022, down by £900m year on year. This large fall in investment coincided with a rise in the main UK clawback rate under the Voluntary Scheme from 5% to 15%, and led to the UK falling from 2nd to 9th out of 18 comparator countries for life sciences FDI in 2022. The Voluntary Scheme clawback rate now sits at a record 26.5% in 2023.

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.

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 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.

The regulatory amendments proposed will enable pharmacists to dispense medicines in their original packaging for private prescriptions starting this Autumn, according to the Department of Health and Social Care. In the recently published draft OPD regulations, the DHSC has indicated that the alterations, permitting pharmacists to vary the dispensed quantity by up to 10 per cent to avoid splitting medicine packs, will be implemented for private prescriptions 'immediately upon the enforcement of the Human Medicines Amendment Regulations in the autumn,' as highlighted in a briefing by Community Pharmacy England. CPE stated that the regulations related to NHS prescriptions will come into effect when the pharmaceutical terms of service regulations expressly apply the OPD amendments. Moreover, new directive mandating the dispensing of sodium valproate products solely in their original packaging (except when an assessment of risk necessitates an alternative approach) will align with the rollout of the private prescription regulations during the autumn. CPE further noted that these regulations are currently in draft, indicating that they are not currently in effect and may undergo revisions prior to their implementation.

Many times, even conventional disease find their solutions in alternative medicines.Here's another example.

Enterosgel is a versatile safe drug-free alternative to current anti-diarrhoeal medicines found on pharmacy shelves. Enterosgel is different from other anti-diarrhoeals within this category, as it is suitable for children aged one year and over, so can be taken by the whole family. This intestinal adsorbent can be used for both acute diarrhoea due to gastrointestinal infections and for chronic irritable bowel syndrome with diarrhoea (IBS-D). Why should community pharmacists stock this brand? Unlike anti-diarrhoeals which work by slowing gut motility, Enterosgel is an intestinal adsorbent which physically binds harmful substances from the gut, that can cause diarrhoea and other gastrointestinal symptoms and expels them naturally with the stools. Because it is a medical device not a medicine, has no pharmacological action and is not absorbed by the body, it is a safe option for children and adults and can help reduce the likelihood of side effects which can be an issue with anti-diarrhoeal medicines. Enterosgel has a unique composition of an adsorbent mineral gel based in water, it contains no additional preservatives or additives so is easy to recommend from vegetarians to people with allergies or intolerances. The gel is mixed with water and taken orally in between meals; it is tasteless so well tolerated even by children.

Saurabh Satija, the Co-founder of CureAssist is a serial entrepreneur & hit upon the idea while working with his last startup - HealthSocho. This company solved availability for alternate medicines, where he kept getting requests from users to recommend products for specific symptoms. "Since it was alternate medicine (Ayurveda, Nutraceuticals, etc.) people thought it was ok to self-medicate on the basis of symptoms." asserts Saurabh. He would consistently request HealthSocho users to visit doctors to understand what their symptom entails and why they should not self-medicate. While some patients would ignore the request, others would talk about geographical constraints and quality of doctors available in their locality.

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 Temazepam 10mg and 20mg tablets. "Temazepam 10mg and 20mg tablets are in limited supply until w/c 5th December 2022. Alternative benzodiazepines and non-benzodiazepine hypnotics remain available and will be able to support increased demand," said DHSC. Temazepam 10mg/5ml oral solution remains available but cannot support an uplift in demand. DHSC suggested: "Where the above options are not suitable, unlicensed supplies of temazepam 10mg tablets may be sourced, lead times vary." The department confirmed that Target Healthcare, a specialist importers, have confirmed they can source unlicensed Temazepam 10mg 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 Temazepam 10mg tablets cannot be issued."

Department of Health and Social Care (DHSC) has issued a medicine supply notification for GLP-1 receptor agonists used in the management of type 2 diabetes on Tuesday (27 June). "There are very limited, intermittent supplies of all glucagon-like peptide-1 receptor agonists (GLP-1 RAs) licensed in the management of Type 2 Diabetes Mellitus (T2DM)," said DHSC. The supply issues have been caused by an increase in demand for these products for licensed and off-label indications and it is not expected to return to normal until at least mid-2024. Pharmacists are urged to refer to the SPS Tool for Medicines Shortages for an up-to-date supply stock situation and clinical guidance on alternative treatment options.

Department of Health and Social Care (DHSC) has issued a medicine supply notification for three tablets- Meptazinol (Meptid) 200mg film-coated tablets, Medroxyprogesterone (Provera) 2.5mg tablets and Lamotrigine 5mg dispersible tablets on Wednesday (15 February). Meptid tablets will remain out of stock until late June 2023. DHSC suggested that an alternative analgesic products including non-opioids remain available. Provera 2.5mg tablets are out of stock until mid-March 2023. "Medroxyprogesterone (Provera) 5mg and 10mg tablets remain available but cannot support an uplift in demand," said DHSC. "Norethisterone 5mg tablets remain available and will be able to support an increase in demand." Branded lamotrigine (Lamictal) 2mg and 5mg dispersible remain available but are unable to support the increase in demand as Lamotrigine 5mg dispersible tablets are out of stock until late March 2023.

Kanabo Group plc, a medical cannabis research and development company, has entered into a partnership with City Dock Pharmacy in London to introduce a walk-in clinic for pain management. The pain clinic will cater to patients who are eligible for alternative therapies (when traditional treatments have failed to deliver improvements), and will offer specialised medicines, including medicinal cannabis. When it opens, the new facility at City Dock Pharmacy in Wapping will become the UK's first walk-in clinic for pain management, but it will also deliver appointment-related services, the companies said. The partnership is part of the London-based company's wider ambition to extend its reach into physical pharmacies throughout the UK, and its plans to replicate this model across other pharmacies.

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.

Community pharmacists are readily accessible healthcare providers and medicine experts in the community setting and their counsel is often sought by patients and consumers on a number of subjects including the use of dietary supplements. Their role in the sale of and advice regarding natural health and drug alternatives has never been more relevant. The recent National Health Service (NHS) Interim People Plan calls for the NHS to put all staff front and centre of the way it operates and identifies pharmacists as a critical part of multidisciplinary teams, providing care across a wide range of increasingly complex patient needs. Despite existing demand to counsel patients on a vast range of medicines, more and more consumers are looking to their pharmacist to support and enhance their knowledge regarding the relevance of a growing range of supplementary nutrients now available. Nutritional supplementation is increasingly becoming the consumer's first choice for 'drug free' treatment or natural prevention that provides a true sense of taking control, which the prescription process often denies them. Historically the immense benefits provided by the NHS have instilled a general abdication of our personal health control, leaving us to rely on the health service to treat and cure as necessary. As our NHS has become visibly over-stretched we begin to realise what the rest of the world has known for centuries - good health is based primarily upon nutritional robustness. It may be stating the obvious but there is an excellent source of incremental revenue for the pharmacist who is willing to provide space to and advice for nutritional supplements.