MANUFACTURING PROBLEMS AS OF 20th June 2017

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1 MANUFACTURING PROBLEMS AS OF 20th June If you know of any stock Issues that are not on this list please get in touch at The information contained in this bulletin is based on information relevant to Dumfries and Galloway on the date displayed and may not apply to other regions. Drug Manufacturer Brand Name Comments Suggested Alternatives Date of first reported issue Adalat La 20mg Bayer plc n/a Out of stock - Expected Mid to end of July 15/06/ Adalat La 30mg Bayer plc n/a Out of stock - Expected End of July Audavate Rd 0.025% w/w Cream Actavis n/a Out of stock -,No date as yet Alphaderm Cream 30g & 100g Alliance Pharma n/a Out of Stock - No date as yet betnovate RD 15/06/ Aquadrate Cream 100g Alliance Pharma n/a Out of Stock - Expected Mid but yet to be confirmed E45 Itch relief Azargo Eye Drop Actavis n/a Limited stock available Bactroban Cream 15g GSK n/a Out of stock - Expected Quarter Ointment is available Betahistine 8mg & 16mg Tablets Variuos n/a Limited stock available review patient need - drug holiday Canesten Pessary 500mg Bayer plc n/a Restricted supply to Wholesalers - Manufacturers expecting delivery end of June use alternative 15/06/

2 Carbocisteine cap 375mg Various n/a Cardicor tablet 1..25mg & 2.5mg x 28 Cetraben Cream 150g & 500g Thornton & Ross n/a Chlorphenamine sf solution 2mg/ 5ml Colestyramine sachets x 50 Teva n/a Limited supply available of some makes but Teva report still in stock Merck Sereno Uk n/a Intermittent supply available - Creon capsules Mylan Creon Betnovate Lotion 100ml GSK n/a Intermittent supply of 500g available - 150g out of stock with no date as yet Various n/a Limited stock available Out of stock - Quality Issue - Until July/September Raw material problem - Limited stock available Out of stock - Expected Mid June Prescribe Generic Epimax Cream Questran Sachets available (formulary choice) Abbott recommend use of 25,000 capsules conversion chart available. Clexane Injections 40mg Sanofi n/a Cutivate Cream 30g GSK n/a Out of stock - Expected Mid July Fragmin injections- ask advice from one of the hospital pharmacist or Dr Pedley /niall Campbell Out of Stock - Expected Mid June 24/05/ Cyclimorph 15mg Injection 1ml x 5 Concordia n/a Diamox SR 250mg capsules Concordia n/a Out of stock - expected end of June Out of stock - Technical Issue - Due end of Quarter 3 Cyclimorph 10mg in stock through Alliance Healthcare - or - Cyclizine injection alone available

3 Diloxanide 500mg tablets Concordia n/a Dilzem Sr 60mg Cap Teva n/a Temporary Discontinued - No date as yet to re-instate Out of Stock - Expected quarter 3 use other brand Distamine 250mg Tablets Alliance Pharma n/a Discontinued 125mg Tablets available Dermovate Cream 30g GSK n/a Intermittent supply - Expected Late June 16/06/ Intermittent supply of 30g - 60g Duac Once Daily 5% x 30g 60g GSK n/a Out of stock - Expected Mid June 30g 15/6/ Entresto Novartis Pharma n/a Limited Stock - Novartis can make urgent supplies directly to contractors within 24 hours Duac Once Daily 3% Gel x 60g GSK n/a Erythormycin 2% Solution x 50ml GSK Stiemycin Discontinued Intermittent Supply - Expected Mid June 30g available 15/06/ Estradot 50microgram Patch Novartis Pharma n/a Limited Supply Available Evorel 50microgram Patch Forceval Soluble Adult 30 Alliance Pharma n/a Out of stock - Expected July Fucidin Cream 15g Leo Pharma n/a Limited stock available Fucidin Ointment 15g & 30g Leo Pharma n/a Engerix B Vial 1 & 10 GSK n/a Engerix B PFS GSK n/a 15g Limited Supply Available - 30g out of stock no date as yet Seek advice from Microbiology Out of Stock - packs of 1's expected early August - packs of 10 expected Mid September 16/06/ Out of Stock - Expected Mid July 16/06/

4 Engerix PF Syringe Adult 1 x 10 GSK n/a Out of stock - expected Q dose 16/06/ Eumovate Cream 30g GSK n/a Intermittent Supply - Expected Mid June 16/06/ Eumovate Cream 100g GSK n/a Out of stock - expected early July Hydromol Intensive 30g & 100g Alliance Pharma n/a Out of stock - Expected Mid - But yet to be confirmed Havrix Monodose PFS 1 & 10'S GSK n/a Out of stock - Pack size 1 expected early August - pack size 10 expected Q Imigran Radis 50mg x 6 GSK n/a Out of stock - Expected early July Isotrex Gel x 30g GSK n/a Discontinued Isotrexin Gel x 30g GSK n/a Out of stock- Expected Late August Out of stock - primary Ingredient Kwells 150microgram & Bayer plc n/a problem - Expected Mid July 300microgram tablets Cinnarizine Lamictal tablets 200mg x 56 GSK n/a Out of stock - Expected early July Letrozole 2.5mg Tablet Various n/a Limited stock available seek consultant advice 16/06/ MST 30mg Tablets Napp n/a Olanzapine all strengths Various n/a Out of stock - MHRA Requesting a review of Documentation - Expected Early July Limited stock available -Some stock with Alliance Healthcare at present - No date of issue resolved as yet All other strengths available switch to Zomorph 15/06/ orodispersible might work as a switch for nonblister pack

5 Navispare Tablet Amco / Mercury n/a Long term manufacturing problem and company are unsure if will return use alternative similar diuretic combination diuretics not recommended in the formulary Orphenadrine 50mg Tablets Teva n/a Teva have Discontinued - Pavacol D Alliance Pharma n/a Phenergan 25mg Tablet Sanofi n/a Potassium Chloride 600mg SR Tablets Discontinued- Both 300ml & 600ml Out of stock - Expected end of June Alliance Pharma Slow K Discontinued by Alliance Pharma Pradaxa 110mg & 150mg Caps Boehringer n/a Limited stock Available Pramipexole Tablet 0.088mg x30 Priadel 400mg Tablets Sanofi n/a Pred Forte eye drops Allergan n/a Variuos n/a Limited stock available For mental health switch to Procyclidine or back up Trihexiphenidyl -Advise do not stop abruptly BD OR TDS as you get Cholinergic rebound Limited stock available - Expected end of June 12/06/ Out of stock - 10ml will not be 5ml Limited Stock available all Available Prednisolone 2.5mg & 5mg ec tablets Alliance Pharma Deltacortril Discontinued by manufacturers - Alliance Pharma do a generic Predniolone ec tablet 2.5mg & 5mg in packs of 30's now - Both in stock

6 Premique tablets 0.625mg/5mg Pfizer n/a Discontinued Prempak-C Pfizer n/a Discontinued both strengths Quinaderm 5% cream x 50g Alliance Pharma N/A Quinaderm 10% cream 25g & 50g Alliance Pharma n/a Quetiapine all strengths Tablet Various n/a Raw material problem - Not expecetd untill Mid 2018 Raw material problem - Not expected untill Mid 2018 Out of Stock - Sandoz have discontinued this line, Aurobindo have limited stocks of 100mg & 300mg with more of these strengths in Quality Control which should be released within 2 weeks, all other strengths out of stock with no date - Consilient health report all strengths should be available within 5-7 weeks 12/06/ Respontin Nebules 1ml & 2ml GSK n/a Discontinued Rhinocort Aqua Nasal Spray 64microgram AstraZeneca n/a Out of stock - No date as yet Securon SR Tablet 240mg BGP Products N/A Out of stock - Expected end of June Senokot Syrup 500ml Variuos n/a Limited stock available - Sofradex eye drops 10ml Sanofi n/a Out of stock - Expected End June Spiolto Respimat Boehringer n/a Limited stock available

7 Sumatriptan Tablet 50mg Various n/a Synflorix vaccine 1PFS GSK n/a Limited stock available - Expected Quarter 2 There are a few products in this therapeutic area, with very similar indications but care needed for example naratriptan cost similar to new sumatriptan price but rizatriptan still reasonable Out of stock - Expected early September 16/06/ Tears Naturale Eye Drops 15ml Alcon n/a Limited stock Available Teoptic 1% Eye Drops Thea Pharmaceuticals N/A Discontinued 2% still currently Manufactured 01/06/ Topirimate tablet 50mg Variuos N/A Limited stock available - No date Trimethoprim Suspension 50mg/5ml Various N/A Traxam Pain Relief 3% gel 100g Concordia n/a Traxam 3% gel 30g concordia n/a Trifluoperazine 5mg tablets n/a Trimovate Cream 30g GSK N/A Limited stock available - No date as yet Out of stock - Technical Issue - non formulary use expected Quarter 4 ibuprofen gel Out of stock - Technical Issue - non formulary use expected Quarter 4 ibuprofen gel Out of stock - Due Mid - Rosemont do a 5mg/5ml solution which is in stock - actually cheaper than tablets per 150ml - 1mg tablets There may be a handling are expensive fee Out of stock - Expected end June 16/06/

8 Varilrix Vial & Dil GSK N/A Out of stock - Expected early Auguats Zantac Syrup 300ml GSK N/A Out of stock - Expected Q Prescribe generic Zantac Tablets 150mg & 300mg GSK n/a Out of stock - Until Q3 Switch to generic Ziagen Oral 240ml x 20mg GSK N/A Intermittent supply - Expected early July 16/06/ Zinacef Injection 250mg x 5 GSK N/A Out of stock - Expected Late June 16/06/ Zinnat tablets 125mg & 250mg x 14 GSK n/a Out of stock - Expected early August pack size of 50's are available Zolmitriptan 2.5mg Tablet Limited stock available - various N/A Expected end of August 12/06/ Zyban 150mg x 60 GSK N/A Out of stock - Expected early July non formulary 16/06/