National Patient Safety Alert: Shortage of pyridostigmine 60mg tablets

National Patient Safety Alert Reference Number: NatPSA/2023/006/DHSC

Date issued: 24th May 2023

Brief description of the problem

Pyridostigmine 60mg tablets are out of stock, resupply is expected week commencing 12 June 2023.

There are three suppliers of pyridostigmine 60mg tablets:

Viatris
Teva
Flynn Pharma

The supply disruption is caused by a combination of manufacturing issues and a resulting increase in demand to other suppliers.

Unlicensed imports of pyridostigmine 60mg tablets can be sourced. Lead times vary.

Actions required

Actions to be completed by 26th May 2023:

Prescribers, pharmacists and staff working in GP practices and specialist clinical teams to identify all patients currently prescribed pyridostigmine 60mg tablets.
Prescribers and pharmacists to determine if patients have sufficient stock to last until expected resupply date, week commencing 12 June 2023.
Patients with insufficient supplies should be referred to their prescriber for a prescription for pyridostigmine 12mg/ml oral solution.
Further actions in the full document.

Advice for all healthcare professionals

Guidance on ordering short dated pyridostigmine 12mg/ml oral solution from Viatris

Viatris have short-dated stock of pyridostigmine 12mg/ml oral solution that will be available to order directly from wholesalers. This stock is due to expire at the end of November 2023.

Guidance on ordering and prescribing unlicensed imports

If there is currently no listing on dm+d for the imported product for prescribers to select using their prescribing systems an EPS prescription for unlicensed pyridostigmine 60mg tablets cannot be issued. Where a prescriber wishes to prescribe a specially manufactured or imported product, an FP10 paper prescription should be issued as ‘ pyridostigmine 60mg tablets (Special Order)‘ and endorsed by the pharmacy as a non-Part VIIIB special with the following information:

Amount dispensed over pack size used;
Invoice price per pack size from which the order was supplied less any discount or rebate;
Manufacturers’/importers’ MHRA licence number;
Batch number of the product supplied;
SP

View full notice here.

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