The Medicines & Healthcare products Regulatory Authority (MHRA) has issued a national patient safety alert for the shortage of seven TB antimicrobials, which includes three Rifampicin products and certain strengths of Rifinah, Rifater, Voractiv and Pyrazinamide tablets.
The supply disruption is caused by a combination of factors and these drugs will be intermittently available till the end of this year.
The medicines hit by shortage includes Rifampicin (150mg and 300mg capsules, 600mg IV solution for infusion and 100mg/5ml oral suspension), Rifinah 300 tablets (rifampicin 300mg/isoniazid 150mg), Rifater tablets (rifampicin 120mg/isoniazid 50mg/pyrazinamide 300mg), Voractiv tablets (rifampicin 150mg/isoniazid 75mg/pyrazinamide 400mg/ethambutol 275mg), and Pyrazinamide 500mg tablets.
The alert stated that Ethambutol tablets, Isoniazid tablets, and Rifinah 150 tablets (rifampicin 150 mg/isoniazid 100 mg) and Mycobutin (rifabutin) 150mg capsules remain available but cannot support a full increase in demand.
Drug manufacturer Sanofi, in agreement with the Medicines Procurement and Supply Chain (MPSC) team at NHS England, is managing available stock by allocating supplies and checking valid prescriptions before releasing the medicine to ensure fair distribution.
Prescribers have been advised to limit prescriptions of affected oral anti-TB medicines to a maximum of one month’s supply to conserve stock.
Primary care clinicians should not prescribe Rifampicin until the shortage is resolved.
Hospital Procurement Teams in NHS Trusts should review stock holdings of all anti-TB agents and proactively work to urgently access stock of licensed or unlicensed supplies, where available.
The patients should be informed about changes to their usual or expected medication, and multi-language patient-facing communications should be provided to inform them of any medication changes.
