Following the changes to pack sizes for Xarelto® (Rivaroxaban) 1mg/ml granules for oral suspension, six more products that require reconstitution have had their pack sizes updated in the NHS dictionary of medicines and devices (dm+d) and the Drug Tariff from May 2024. This follows the identification by Community Pharmacy England of pack size listing discrepancies where the pack sizes previously listed did not represent the actual usable volumes after reconstitution as set out in their respective SmPCs.
The NHS dm+d Content Committee agreed to representations made by Community Pharmacy England to change the pack size information on dm+d for the following products. Where an SmPC for an oral solution or oral suspension publishes both a reconstituted volume and a usable volume, and these are different, the NHS dm+d Content Committee has made the pragmatic decision that the pack size on dm+d will be based on the published usable volume.
From 1 May 2024, dm+d and Drug Tariff have been updated to express the new pack sizes as the usable volumes for the following 6 products and packs listed in the table below,
Product
Previous pack size listing
New pack size listing based on actual usable volume after reconstitution (effective 1 May 2024)
Listed in the Drug Tariff
Special container (complete pack size)
CellCept® (Mycophenolate mofetil) 1g/5ml oral suspension
175ml
160ml*
Yes
Yes
Revatio® (Sildenafil) 10mg/ml oral suspension
112ml
90ml
Yes
Yes
Sprycel® (Dasatinib) 10 mg/mL oral suspension (Imported (Germany))
99ml
90ml
No
Yes
Tamiflu® (Oseltamivir) 6mg/ml oral suspension
65ml
50ml
Yes
Yes
Valcyte® (Valganciclovir) 50mg/ml oral solution
100ml
88ml
Yes
Yes
VFEND® (Voriconazole) 40mg/ml oral suspension
75ml
70ml
Yes
Yes
* Where a usable volume range is presented in the SmPC the lowest level of the usable volume will be the pack size published on dm+d and in the Drug Tariff, where applicable.
Due to the lag in updating of prescribing systems to reflect these changes, pharmacies may continue to receive prescriptions for the older pack sizes. Until prescribing systems have updated and ‘mapped’ across new product codes (with updated pack sizes) by using the latest dm+d extract, pharmacy teams may need to seek clarity from the prescriber regarding the quantity required by the patient and request amendments to prescriptions, where appropriate.
Please note: All the affected products are classed as special containers and payment will continue to be based on special container rules. For example if 175ml (old pack size) of CellCept® is ordered on an NHS prescription, pharmacy owners will continue to be reimbursed for the complete pack size dispensed.
The post Products requiring reconstitution – pack size changes appeared first on Community Pharmacy England.