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Diamorphine 5mg and 10mg powder used for solution for injection ampoules will remain unavailable until February 2022, Department of Health and Social Care (DHSC) has said in an update. These injection ampoules are used to treat severe pain associated with surgical procedures, pain in the terminally ill, and to provide relief in acute pulmonary oedema. Diamorphine 30mg and 100mg ampoules are available, however, the stock is not enough to support an uplift in demand. Separately, the DHSC has extended the Medicine Supply Notification for Kolanticon gel, which is expected to remain unavailable until October 2022.

Pharmacists are being notified of a limited supply of hydrocortisone sodium phosphate 100mg/1ml solution for injection ampoules, with stock expected to be exhausted by late March 2025. The Department of Health and Social Care (DHSC) has issued a medicine supply notification, indicating that resupply is not anticipated until May 2026. NHS provider Trust pharmacy procurement and clinical teams are advised to collaborate in reserving existing stock of the solution for injection, specifically for patients who require hydrocortisone sodium phosphate during an adrenal crisis. The DHSC added that this stock has an expiry date of June 2025. Hydrocortisone is used to replace steroids in individuals with adrenal insufficiency, such as those with Congenital Adrenal Hyperplasia (CAH) or Addison's disease, where the adrenal glands produce insufficient natural steroids. People with adrenal insufficiency or anyone who is "steroid-dependent" require a hydrocortisone emergency injection kit to prevent an acute adrenal crisis, which can be life-threatening.

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.