The Royal College of Ophthalmologists and the UK Ophthalmic Pharmacy Group are aware of shortages of essential eye drops and drugs, often at short notice.
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, but shortages have occurred for various reasons eg shortages of raw materials/plant failure/imbalance between supply and demand.
Manufacturers are subject to obligations under Department of Health/industry joint guidance:
The guidance recommends companies inform the Department of Health as soon as possible about impending shortages that are likely to impact on patient care and also to consider whether/how best to communicate about a supply problem to the NHS.
The Department of Health has also published guidance on notification of product discontinuation, advising companies to provide advance warning so that the potential impact on patient care may be planned for and appropriately addressed: https://www.gov.uk/government/publications/notification-of-product-discontinuations-pharmaceuticals
RCOphth and UKOPG intend to provide regular bulletins updating our members about known current and potential product shortages/discontinuation. If members become aware of drug shortages not listed please contact the College via firstname.lastname@example.org
RCOphth Quality and Safety Group
UK Ophthalmic Pharmacy Group
|Medication||Brand Name||Manufacturer||Reason for shortage||Likely duration of stock shortage||Potential alternatives*|
|Acetazolamide 250mg MR tablets (Updated 16 March 2018)||Diamox SR
|No reason given
Problems with manufacturing process/formulation
|April – June 2018
Stock will be with wholesalers w/c 2 April 2018
|Immediate release acetazolamide remains unaffected.
Importers have confirmed that they can source unlicensed acetazolamide MR from abroad
|Brinzolamide and timolol combination eye drops
(Updated 16 March 2018)
|Azarga||Novartis||There have been recent shortages due to a significant increase demand; the company is responding to the increase and is waiting for the next batch to be released||Now back in stock||Supplies from December have unfortunately been exhausted.
There are numerous manufacturers of dorzolamide and timolol combination eye drops and supplies remain unaffected
|Dexamethasone 0.1% eye drops (Updated 16 March 2018)||Maxidex||Novartis||No details||Stock will be with wholesalers w/c 19 March 2018||The shortage only affects the 10ml product, the 5ml product is freely available|
|Liquid paraffin with white soft paraffin wool alcohols (added 20
|Lacri-lube eye ointment||Allergan||Manufacturing issues at sole global manufacturing site||The manufacturer can provide no details||Xailin Night eye ointment (contains white soft paraffin, white mineral oil and lanolin alcohols)|
|Apraclonidine 5mg/mL eye drops (added 16 March 2018)||Iopidine||Novartis||Awaiting release of new batch from QA||Stock has been returning to wholesalers w/c 12 March 2018||Stock should now be available|
|Brinzolamide and brimonidine combination eye drops (added 16 March 2018)||Simbrinza||Novartis||Awaiting a new delivery||Stock is expected to be with wholesalers w/c 19 March 2018||Separate components freely available|
|Carmellose 1% eye drops 30 unit dose pack (added 16 March 2018)||Celluvisc||Allergab||No details||Mid March 2018||Supplies of 60 unit dose pack remain unaffected|
|Timolol 0.25% and 0.5% unit dose (added 16 March 2018)||Timoptol||Santen||Product is being discontinued on 31 March 2018||N/A||Numerous preservative free alternatives available including timolol 1mg/g gel and levobunolol 5mg/mL unit does eye drops|
*It is recognised that there will be regional variation in appropriate alternatives in accordance with local formularies