A photo of a pile of pills and a thermometer.

Drugs Shortages

The Royal College of Ophthalmologists works with the UK Ophthalmic Pharmacy Group to update our members on drug shortages. This is not intended as a guide to patients, who should always speak to their consultant, pharmacist or other medical professional about finding alternative medication. The College is unable to offer advice to patients on where to source specific drugs or possible alternatives.

In response to concerns raised by the College, the Department of Health Medicine Supply Team has confirmed that manufacturers have a legal duty to ensure continuity of supply of medicines to UK patients.

Joint industry and Department of Health guidance recommends companies inform the Department of Health as soon as possible about impending shortages which are likely to have an impact on patient care. When prior notification of product discontinuation or shortage is provided potential impact can be planned for and addressed by the Department of Health.

Contact us

If members become aware of drug shortages not listed please contact Jonathan Baker, Quality Improvement Manager: [email protected].

Current drugs shortages

Shortages can occur for various reasons including shortages of raw materials/plant failure/imbalance between supply and demand. Below you’ll find an regularly updated list of drug shortages that the College and UKOPG are aware of.

(Added 11 March 2022)

Brand Name: N/A       Manafacture: Guys’ and St Thomas’

Reason for Delay: Manfacturing Delay

Likely duration of stock shortage: Early April 2022

Potential alternatives*: No direct alternative exists. Cystadrops might be appropriate if preservatives can be tolerated. Be aware this is commissioned by NHS England as per this policy

(Added 21/01/2021)

Brand Name: Visudyne          Manufacturer: Cheplapharm
Reason for shortage: Out of stock

Likely duration of stock shortage: mid-2021

Potential alternatives*: US Visudyne (considered unlicensed in the UK) is being supplied by their distributor, Neon Healthcare, in restricted quantities until this time.  Please contact Neon Healthcare with any queries: 01920 444 345 or [email protected]

The following specialist importers have also confirmed they can source unlicensed imports of verteporfin 15mg injection, lead times vary (please note, there may be other companies that can also source supplies):

  • Durbin PLC
  • Mawdsley’s Unlicensed.

(Added 3 March 2020)

Brand Name: N/A          Manufacturer: RPH

Reason for shortage: Manufacturing delay
Likely duration of stock shortage: Until 13 March 2020

(Added 12 February 2020)

Brand Name: Miochol-E             Manufacturer: Bausch and Lomb
Reason for shortage: Limited supplies until mid-March 2020 – imports available.

(Updated 12 February 2020)

Brand Name: N/A          Manufacturer: Bausch and Lomb
Reason for shortage: Problem with API

Likely duration of stock shortage: 0.5% and 1% out of stock until mid-March 2020

Potential alternatives*: Mydrilate remains in stock

Use multi dose preserved cyclopentolate eye drops where appropriate. If this is not appropriate consider tropicamide 1% or phenylephrine 2.5% but be aware that phenylephrine 2.5% is also in short supply.

Consider atropine 1% if there is no other safe alternative.

Cyclopentolate hydrochloride must be reserved for cycloplegic refraction.

(Updated 12 February 2020)

Brand Name: Mydrane          Manufacturer:  Thea Pharmaceuticals

Likely duration of stock shortage:  Out of stock until 20 February 2020

Potential alternatives*: Supplies of Mydriasert remain robust. Reserve any remaining supplies of Mydrane for those patients in which an alternative is not available i.e. intraoperatively if IFIS is suspected.

Brand Name:N/A          Manufacturer: Kyowa Kirin
Reason for shortage: Quality control release and manufacturing concerns MHRA Alert

Likely duration of stock shortage: Ceased production

Potential alternatives*: Please see link for alternative suppliers

Etabonate 0.5% eye drops

(Updated 17 January 2020)

Brand Name: Lotemax          Manufacturer: Bausch and Lomb
Reason for shortage: Unknown

Likely duration of stock shortage: Unknown

Potential alternatives*: No direct alternative. Consider an alternative corticosteroid with a similar potency such as FML (fluorometholone) or prednisolone 0.5% eye drops. Monitor closely for response and consider additional IOP monitoring if appropriate.

(Updated 19 December 2019)

Brand Name: Zovirax          Manufacturer: GlaxoSmithKline UK Ltd
Reason for shortage: Discontinuation

Likely duration of stock shortage: GSK will cease the manufacture and supply of Zovirax Eye Ointment globally during 2018 due to repeated challenges in guaranteeing a sustainable product supply. Stock of Zovirax Eye Ointment is anticipated to continue to be available in the UK until the end of March 2019. See full notification DHCP Zovirax Eye Ointment Discontinuation Letter 13.12.18

Potential alternatives*: Please refer to the UKMI memo on the discontinuation of Zovirax Eye Ointment for further information on alternative treatment options. A new licensed product may now be available.

(Updated 4 November 2019)

Brand Name: N/A          Manufacturer: RPH Pharmac-euticals AB (distributed through Focus Pharmaceuticals)
Reason for shortage: Discontinuation

Likely duration of stock shortage: RPH Pharmaceuticals AB, have advised that following the discontinuation of Betnesol Eye Ointment 0.1% w/w x 3g they have experienced manufacturing problems which have resulted in the nonviability of launching a generic Betamethasone Eye Ointment 0.1% w/w x 3g.

Potential alternatives*: RPH Pharmaceuticals NOT will be launching a generic. Martindale Pharma can support the market in the meantime.

(Updated 12 August 2019)

Brand Name: Lacri-lube eye ointment          Manufacturer: Allergan
Reason for shortage: Manufacturing issues at sole global manufacturing site

Likely duration of stock shortage: Out of stock due to an ongoing manufacturing issue. Allergan are unable to provide a re-supply date at this stage.

Potential alternatives*: Xailin Night eye ointment (contains white soft paraffin, white mineral oil and lanolin alcohols) and HYLO NIGHT (formerly VitA-POS) (contains retinol palmitate (vitamin A), liquid paraffin, light liquid paraffin, wool fat and white soft vaseline).

(Updated 20 November 2018)

Brand Name: Timoptol           Manufacturer: Santen
Reason for shortage: Product is being discontinued on 31 March 2018

Likely duration of stock shortage: N/A

Potential alternatives*: Numerous preservative free alternatives available including timolol 1mg/g gel and levobunolol 5mg/mL unit does eye drops. Preservative free multi-dose 2.5mg/ml and 5mg/ml timolol eye drops are available as potential alternatives.

(Added 6 June 2018)

Brand Name: Rapitil            Manufacturer: Sanofi
Reason for shortage: This product has now been discontinued

Likely duration of stock shortage: N/A

Potential alternatives*: Numerous mast cell stabilisers remain available including sodium cromoglicate and lodoxamide.