GPs are being asked to contact patients taking fluoxetine to check what supplies they have at home in response to national shortages of the drug.
In a letter sent out to GPs on the 20 September, the Department of Health and Social Care said that due to manufacturing problems, there would be supply problems with some doses of fluoxetine capsules until early November.
The DHSC called on GPs and prescribers to identify all patients currently prescribed fluoxetine 10mg, 30mg and 40mg capsules and contact them to find out if they have enough supply at home to last them until early November.
Any patient with enough of their medication should not be issued a repeat prescription in this time, the letter stated.
For those who are likely to run out, GPs have been given a list of alternatives including in some cases unlicensed 10mg capsules that are being sourced from abroad.
And other doses such as 2x20mg capsules can be used to make up a 40mg prescription, according to the letter.
It said: ‘Due to the long-term issues affecting fluoxetine 10mg, 30mg and 40mg capsules, we recommend the following actions be undertaken.
‘GPs and prescribers should identify all patients currently prescribed fluoxetine 10mg, 30mg and 40mg capsules. Early contact should be made with the patient or patient’s parent/carer to determine if the stocks at home will last until early November.
‘If the patient has sufficient supplies to last them until early November, then no further action is required. These patients should not be issued with a repeat prescription during this period.’
Professor Azeem Majeed, head of primary care at Imperial College London, said this advice would lead to ‘a lot of’ extra work for GPs.
He said: ‘Contacting patients would be a lot of work for practices as fluoxetine is a commonly-prescribed drug. This illustrates how shortages of key drugs, as well as being stressful for patients, is also leading to extra work for practices and pharmacists at a time when they are already under considerable workload pressures.’
In another DHSC letter sent out the same day, GPs were also informed that Provera (medroxyprogesterone acetate) 100mg tablets will be out of stock until the 8 November.
For patients who do not have sufficient supplies clinicians should consider prescribing an unlicensed preparation of medroxyprogesterone tablets as soon as possible, the letter said.
GPs were also advised to consider identify patients proactively to ‘minimise disruption this may cause locally in terms of patients seeking GP appointments’.
A Department of Health and Social Care spokesperson said: ‘We are aware of an issue with fluoxetine capsules from two UK manufacturers. However, supplies of alternative presentations of fluoxetine remain available from a number of manufacturers including the brand Prozac.
‘We have been working closely with NHS England and national experts and have issued advice on management options to the NHS to ensure patients can continue to be managed appropriately during this time.’