National Patient Safety Alert: Shortage of pyridostigmine 60mg tablets
National Patient Safety Alert Reference Number: NatPSA/2023/008/DHSC
Date issued: 18th July 2023
Brief description of the problem
There are very limited, intermittent supplies of all glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
Actions to be completed by 18th October 2023:
Actions for clinicians and prescribers of GLP-1 RAs until supply issues have resolved
Only prescribe GLP-1 RAs for their licensed indications.
Do not initiate new patients on GLP-1 RAs for the duration of the shortage.
Proactively identify patients established on affected GLP-1 RAs and consider prioritising for review based on the criteria set out in the clinical guidance and:
i. discuss stopping treatment with patients who have not achieved treatment targets as per NICE CG28 or NICE CG189
ii. do not switch between brands of GLP-1 RAs, including between injectable and oral forms.
iii. do not double up a lower dose preparation where a higher dose preparation of GLP-1 RA is not available.
iv. do not prescribe excessive quantities; limit prescribing to minimise risk to the supply chain whilst acknowledging the needs of the patient.
Use the principles of shared decision making where an alternative agent needs to be considered, as per NICE guidelines and in conjunction with the clinical guidance.
Support patients to access structured education and weight management programmes where available.
For type 2 diabetics; If switching a patient on to insulin, please ensure an insulin is chosen as per information on the SPS page on prescribing available insulins as not all suppliers are able to manage an uplift in demand.
Please see full guidance in the alert.
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