Medication Shortages - Next Steps

Reaching into your bag for medication to head off symptoms of a migraine, you realise you have just two tablets left and it is time to fulfill your repeat prescription. But the pharmacy does not have the treatment you need; the pharmacist tells you that it is out of stock. What does this mean?

The phrase ‘it is out of stock’ is rather simple at face value. They don’t have the item to dispense it at the pharmacy. But why? Did they forget to order it from the wholesalers? Perhaps the weather increased the sales of the medication and the last pack of tablets was sold ten minutes before you entered?

It could be any of these reasons or others. But often, ‘out of stock’ will continue for a few weeks, and at that point, it becomes more than a minor inconvenience.

It could be that the manufacturers have found an issue with a certain batch and were obliged to recall the medication from the shelves for patient safety. Or there could be problems with the manufacture of the active ingredient. The possibilities are endless and although it is frustrating for the patient as well as the pharmacy team, often there are no dates of availability provided.

So here is a guide to what is currently out of stock, why (as far as has been disclosed by the manufacturers) and how to work around the issue.

1. Triptans - this series of migraine medications has had issues since late 2016, first with Zolmitriptan, quickly followed by Sumatriptan and then Rizatriptan. These are now much harder to get your hands on and when you do, the high prices may make you wince. The official note on this class is increased demand, causing a UK-wide price hike.
2. Duac - GSK quotes temporary supply problems or ‘manufacturing difficulties’, with Duac 3% out of stock until end of Sep, 2017, while Duac 5% has an intermittent supply and will not be fully available for a few months.
3. Isotrex - the production of this anti-acne treatment was discontinued and the medication has been taken off the market for good. Reasons as to why this is are vague, so if you use this one, it might be best to make an appointment with your pharmacist for alternatives.
4. Hepatitis A Vaccine - those travelling to countries where there is a risk of contracting Hep A will probably already be aware that there is currently a global shortage of this vaccine, which is severely impacting supply throughout the UK. Again, the cause is unknown but it is important to make an appointment with a pharmacist or a travel clinic to get up-to-date information and advice based on the current situation.

Why do some pharmacies still have it?

You might notice that some pharmacies will have a certain line in stock where your local branch did not. Usually, this is existing stock secured before the market shortage. If you are looking for a particular brand/generic version of the medication, ask your pharmacist.

So what can I do?

While the generic version of the medications are in short supply, their branded versions might still be available on the market. Some patients prefer to buy the branded versions of their medications, but many are happy to take the generic versions, which are medically equivalent. Since these versions come without the attached branding and advertising, they are cheaper and therefore, popular. If you are looking to treat a migraine, chances are that branded Imigran (sumatriptan), Maxalt (rizatriptan) and Zomig (zolmitriptan) are still available in certain pharmacies.

For duac, it is best to seek advice from your doctor or pharmacist, who will be able to give you advice based on your individual situation and give you alternative solutions.