Vaccine update: PHE COVID-19 vaccination programme special edition is available here.

The manufacturer's decision to discontinue Priadel (lithium carbonate tablets) has been reversed for now. There is currently no need to switch patients receiving Priadel to a different brand of lithium carbonate. For further information see the lithium section of this formulary. Updates will be posted when available. 

Priadel discontinuation - current advice from Oxford Health:

For patients currently prescribed Priadel - guidance on how to switch will be available soon. In the meantime continue to prescribe Priadel. See further advice in the Drugs & Therapeutics Group information bulletin, including information for community pharmacists about how to obtain continued supplies.

For new patients requiring treatment with lithium carbonate - do not initiate a new prescription with the Priadel brand. OH recommend initiating with either Liskonum or Camcolit brand. For more detailed advice, including some important differences, please see "How to start Liskonum or Camcolit (lithium carbonate modified release tablet)" guidance. Also linked from the lithium section of this formulary.

**Priadel to Camcolit switch guidance will be available soon**

Important differences in the supply of Clenil beclometasone 100microgam inhalers. In order to help maintain supplies, additional batches of this inhaler are being released into the NHS Supply Chain. However there are some key changes to be aware of that are detailed on the suppliers website and include a difference in how the inhaler looks.

Sertraline supply issues - We are aware that some community pharmacies are reporting difficulties obtaining sertraline 50mg and 100mg tablets. It has been confirmed that there is no national shortage of sertraline tablets, therefore switching patients to an alternative treatment is not necessary and is not being advised.

As different pharmacies obtain medication supplies from different wholesalers, we suggest that patients experiencing this problem should try taking their prescription to a different pharmacy. Further details and guidance is available here.

Depakote shortage - alternative options and prescribing guidance.

Guidance for clinicians who are prescribing remotely to outpatients during the coronavirus outbreak.

Clozapine and coronavirus/COVID-19 - information for healthcare professionals

ACE-Inhibitors / Angiotensin Receptor Blockers and coronavirus - Position Statement from the European Society of Cardiology Council on Hypertension

Anti-inflammatories and coronavirus - NHS Medical Director advice to clinical staff *UPDATED 14th April*

Managing missed doses or treatment breaks of memory medication - updated medicines advice bulletin now available. Click here.

*** DRUG SHORTAGE INFORMATION ***

DIAMORPHINE INJECTION

It is anticipated that there will be a stock shortage of diamorphine 5mg and 10mg injection from March 2020 that may not resolve until summer 2020. Further detailed information about this issue and alternatives can be found at this link and from the diamorphine entry within this formulary.

***DRUG SHORTAGE INFORMATION***

CLONIDINE 25 MICROGRAM TABLETS

There is a long term supply issue with clonidine 25 microgram tablets. No resolution date is yet known. Please see the medicines shortage bulletin for more information.

Abrupt withdrawl is not recommended due to the severe risk of rebound hypertension. Cases of agitation, restlessness, palpitations, nervousness, tremor, headache and abdominal symptoms have also been reported.

***DRUG RECALL INFORMATION***

Emerade (adrenaline) 150, 300, 500 microgram autoinjector devices recall: All batches of Emerade have been recalled and no further stocks will be available in the foreseeable future. Staff are advised to use adrenaline ampoules for intramuscular administration when needed.

***TEMPORARY DRUG SHORTAGE INFORMATION***

MOCLOBEMIDE

There is a temporary manufacturing supply issue with moclobemide affecting both strengths (150mg and 300mg).

- One manufacturer is out of stock of both stengths and does not have a date for resupply.

- The other currently has stocks of 150mg but the 300mg are currently out of stock and not expected back into stock until early next year.

Delmosart 18mg is out of stock again resolution date expected to be 18/11/19. All other strengths remain available. Recommended alternatives to use until the issue is resolved are Xaggitin or Concerta XL.

Supply issue RESOLVED: Delmosart 18mg and 27mg strengths will be back in stock at wholesalers from today (5th August).

The July 2019 Drugs & Therapeutics Group Bullet Point summary includes links to updated and new policies, guidelines, shared care protocols, new drugs, drug shartages and more. Please click on this link to open the 3 page summary.

Cariprazine has been added to the formulary as a restricted medicine. It can be used in patients with schizophrenia as a second line treatment where negative symptoms predominate. For further information about the DTG decision and restriction and for prescribing information click here.

***TEMPORARY DRUG SHORTAGE*** Delmosart 18mg and 27mg tablets are temporarily unavailable. The 36mg and 54mg remain available. The manufacturer describes the shortage as short term, but is unable to provide a resolution date currently. Updates will be posted here when known. Bioequivalent alternatives that could be prescribed in the interim include Xaggitin XL or Concerta XL.

Shared Care Best Practice Guideline - Oxfordshire CCG has published a joint document with the OUH and Oxford Health that aims to improve the communication of shared care.

Phenelzine shortage: the sole manufacturer of phenelzine has announced that they will be out of stock of phenelzine between August and at least October. There are more details available on the Specialist Pharmacy Services website and we will add all updates to our formulary pages.

Updated OHFT Behavioural and Psychological Symptoms of Dementia (BPSD) guideline now available. Click here.

There is currently a shortage of diamorphine 5mg injection. For more info click here

The Trust is using a new clozapine assay service - click here for further details.

Flupentixol depot supply problems - generic flupentixol (Psytixol - all strengths) has been out of stock since the end of January. However, the branded version - Depixol - remains available and the manufacturer has confirmed that there is no supply problem with this preparation.

An update is available for mobile NetFormulary App users. Instructions are available for updating your app by clicking here.

Clomipramine shortage update: 25mg and 50mg capsules are now available. the 10mg capsule is unavailable and stock not expected until June 2019.

There is a temporary shortage of UK-licensed lorazepam injection. For information on the alternative being supplied to wards during the shortage, please click here.

A temporary interruption of the supply of Epanutin (phenytoin) 30mg/5ml oral suspension, which may last until early December 2018, has been announced by Pfizer.

OH Medicines Safety Action Note issued: Valproate Pregnancy Prevention Programme. Click here.

Pharmacy and Dispensing Practice Q&A regarding adrenaline (Epipen and Epipen Junior) supply issue [NHS Gateway]: click here.

Adrenaline auto-injector (Epipen) shortage - SUPPLY DISRUPTION ALERT. More details available here.

Drugs & Therapeutics Group bullet point summary Jan - June 2018 available here.

STOMP: Stopping OverMedication of Patients with a Learning Disability - NHS England encourages more to sign up to the STOMP pledge

Valproate banned without the Pregnancy Prevention Programme

Drugs & Therapeutics Group Bullet Points 2017/2018 available here.

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