The company has run out of remaining warehoused stocks of 1ml ampoules of hydrocortisone sodium phosphate and expects it will be unable to resume supply until Q3 2018.
A similar manufacturing problem in Q4 2014 was not resolved until Q3 2015, when the former branded product Efcortesol was relaunched as the current generic. The previous licence holder, Amdipharm, has since been taken over by Concordia, a Canadian-headquartered generic drug producer.
Once the remaining warehoused stocks held by wholesalers and hospitals have been depleted, anyone who needs to renew their injection kit materials will have to ask their GP to issue a prescription for the alternative form of injectable hydrocortisone:
- hydrocortisone sodium succinate (Solu-Cortef) 100mg powder, with a 2ml ampoule of solvent (sterile water)
Outside the UK (Ireland, Europe and Americas) you may also be able to obtain the Act-o-Vial preparation, containing hydrocortisone sodium succinate and water in a chambered ampoule.
Guidance for GPs on what to prescribe can be found in the ADSHG’s GP Care leaflet. GPs are reminded that none of the alternative liquid injectable steroid preparations, eg Hydrocortistab (hydrocortisone acetate) are suitable for emergency use, being slow-acting preparations for joint injections.
The Department of Health's Medicines Supply team is aware of the issue and in contact with both Concordia and Pfizer. It is closely monitoring the situation and has notified Clinical Commissioning Groups within NHSE of this shortage. It has also notified NHS Scotland, Wales and Northern Ireland of the shortage. The DH team has commissioned the following guidance which you can read on this link.
As any further information becomes available, we will update members in the member-only online forum.