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 Beth.Barnes@rcophth.ac.uk
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 7 December 2017)||Diamox SR
|No reason given
Problems with manufacturing process/formulation
|Immediate release acetazolamide remains unaffected.
Importers have confirmed that they can source unlicensed acetazolamide MR from abroad
|Brinzolamide and timolol combination eye drops
(Updated 7 December 2017)
|Azarga||Novartis||Product has recently been divested by Alcon||Supplies now available||There are numerous manufacturers of dorzolamide and timolol combination eye drops and supplies remain unaffected|
|Dorzolamide 2% and 0.5% timolol preservative free eye drops (Updated 14 December 2017)
||Cospot preservative free||Santen||Manufacturing issue||Supplies now available||Numerous generic versions of dorzolamide and timolol preservative free eye drops remain available|
|Isopto Plain 0.5% eye drops (Updated 7 December 2017)||Hypromellose 0.5% eye drops||Novartis||No details||Supplies now available||Numerous other generic versions available|
|Fluorescein 10% injection
(Updated 14 December 2017)
|Anatera 100mg/ml||Novartis||No details||End of December 2017||An alternative preparation can be ordered from Oxford Pharmacy Store 500g/5ml ampoules available|
|Dexamethasone 0.1% eye drops (added 14 December 2017)||Maxidex||Novartis||No details||The manufacturer can provide no details||The shortage only affects the 10ml product, the 5ml product is freely available|
*It is recognised that there will be regional variation in appropriate alternatives in accordance with local formularies