From time to time the RANZCP is notified of shortages of reportable medicines in Australia.
This page lists current alerts received from the Therapeutic Goods Administration (TGA), together with actions you can take to manage the shortage.
For more information and to subscribe to updates, see the TGA’s Medicine Shortages Information Initiative.
If you know of a shortage, you can tell the College by emailing ranzcp@ranzcp.org
7 May 2021 | Fluoxetine
LOVAN TAB Fluoxetine (as hydrochloride) 20mg tablet blister pack (AUST R: 61080) is currently unavailable until 31 December 2021.
LOVAN fluoxetine 20mg (as hydrochloride) capsule blister pack (AUST R: 54700) is currently unavailable until 31 December 2021.
ZACTIN TABS fluoxetine hydrochloride 20mg dispersible tablet blister pack (AUST R: 90913) is currently unavailable until 14 May 2021.
ZACTIN fluoxetine 20mg (as hydrochloride) capsule blister pack (AUST R: 53773) is currently unavailable until 30 June 2021.
Fluoxetine is currently available under Section 19A. Please see here for further information.
Please visit the TGA website for guidance regarding Section 19A.
Please refer to the TGA Medicine Shortages Database for more.
7 May 2021 | Sertraline
SERTRALINE-STR sertraline (as hydrochloride) 50 mg tablet blister pack (AUST R: 107067) is currently unavailable until 23 April 2021.
SERTRA 100 sertraline (as hydrochloride) 100 mg tablet blister pack (AUST R: 213181) is currently unavailable until 14 May 2021.
ELEVA 100 sertraline (as hydrochloride) 100 mg tablet blister pack (AUST R: 95583) is currently unavailable until 30 June 2021.
SETRONA sertraline (as hydrochloride) 100 mg tablet blister pack (AUST R: 116636) is currently unavailable until 31 May 2021.
ELEVA 100 sertraline (as hydrochloride) 100 mg tablet bottle (AUST R: 95584) is currently unavailable until 30 June 2021.
SERTRALINE GENERICHEALTH sertraline100mg (as hydrochloride) tablet blister pack (AUST R: 124856) is currently unavailable until 31 May 2021.
ELEVA 50 sertraline (as hydrochloride) 50 mg tablet bottle (AUST R: 9558 is currently unavailable until 30 June 2021.
APO-SERTRALINE sertraline (as hydrochloride) 50mg tablet blister pack (AUST R: 213177) is currently unavailable until 2 July 2021.
Sertraline is currently available under Section 19A. Please see here for further information.
Please visit the TGA website for guidance regarding Section 19A.
Please refer to the TGA Medicine Shortages Database for more.
7 May 2021 | Tofranil
Tofranil 25 imipramine hydrochloride 25mg tablet blister pack (AUST R: 60673) is currently on emergency supply until 31 May 2021.
TOFRANIL 10 imipramine hydrochloride 10mg tablet blister pack (AUST R: 11064) is currently unavailable until 31 July 2021.
Pro Pharmaceuticals Group Pty Ltd advises that Imipramine 25mg tablets are available as Section 19A.
Orders can be placed via Pro Pharmaceuticals Group Pty Ltd website or emailing orders@propg.com.au or via Symbion Wholesalers PDE: 692379.
Please visit the TGA website for guidance regarding Section 19A.
11 February 2021 | Shortage of Nardil (phenelzine)
The Therapeutic Goods Administration (TGA) has authorised two sponsors to supply an overseas-registered brand of phenelzine under Section 19A of the Therapeutic Goods Act 1989.
The overseas-registered brand of phenelzine is named Phenelzine Sulfate USP 15 mg tablets (Lupin Pharmaceuticals).
The Section 19A product sponsored by Generic Health is now subsidised through the Pharmaceutical Benefits Scheme (PBS).
Health professionals should contact the Section 19A approved sponsors on the above phone numbers for further information or to arrange supply.
Please visit the TGA website for guidance regarding Section 19A.
The shortage is due to global issues with the manufacture of the active pharmaceutical ingredient.
The Therapeutic Goods Administration, the Royal Australian and New Zealand College of Psychiatrists, and the Society of Hospital Pharmacists of Australia have issued a joint statement on accessing alternatives and patient care.
This statement includes:
- information about options for obtaining phenelzine through an alternative access pathway
- advice for prescribers about switching patients from phenelzine to another treatment.
Importantly, a number of patients will have used phenelzine for many years, often with a resolution of symptoms no other anti-depressant has achieved. There will be considerable anxiety and distress in this community about this discontinuation. GPs are advised to consult with a psychiatrist regarding treatment options and transition. Ideally, a patient on phenelzine should be reviewed by a psychiatrist.
RANZCP members are asked to please ensure liaison with GPs regarding treatment options and transition in managing patient care.
From time to time the RANZCP is notified of changes to New Zealand Pharmaceutical Schedule or an adverse medicine reaction in New Zealand.
When notifications become available they will be published here.
30 July 2021 | Message from PHARMAC regarding prazosin
We recently notified of the discontinuation of prazosin. This follows a decision from Apotex, a pharmaceutical supplier to leave the New Zealand market. We have been unable to find an alternative supplier for prazosin.
You can read more detail about this (including key dates) on the Pharmac website.
We have been contacted by the RNZCGP indicating that prazosin is prescribed for the management of symptoms relating to PTSD and asking for Pharmac’s advice on what an alternative treatment may be for patients. We are aware that the New Zealand Formulary recommends that prazosin (and clonidine) for PTSD should only be initiated by a mental health specialist, or after discussion with a mental health specialist.
With the discontinuation of funding of prazosin, we wanted to let RANZCP know in case there is increased contact to specialist mental health/psychiatry services from other members of the wider mental health team or other primary care providers seeking advice on alternative treatments.
We know changing treatments can sometimes be difficult for people. This might be especially the case for those with PTSD symptoms. We acknowledge the inconvenience this may cause.
13 May 2021 | Medsafe — Latest evidence on antidepressants and postpartum haemorrhage risk
In March 2021, the Medicines Adverse Reactions Committee (MARC) reviewed the evidence on postpartum haemorrhage when selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are used in the month prior to delivery.
The risk is considered to be small – there may be 1 excess case of postpartum haemorrhage for every 80-100 people taking SSRI/SNRI antidepressants close to the time of delivery. The antidepressants discussed were citalopram, escitalopram, fluoxetine, sertraline, paroxetine, and venlafaxine. The risk may also apply to vortioxetine.
The MARC would like to remind practitioners to continue to consider the benefits and risks for use of SSRI/SNRI antidepressants during pregnancy, including:
- the individual bleeding risk of the person during the peripartum period
- the risk of untreated depression and the benefits of continuing antidepressants for the person’s mental health.
- The MARC do not wish to imply that practice should be changed.
More information can be found in the MARC report on Medsafe’s website.
30 July 2020 | Ritalin sustained release 20mg – discontinuation in New Zealand
Novartis is internationally discontinuing its 20 mg dose of methylphenidate hydrochloride sustained release (brand name Ritalin SR).
Other formulations of Ritalin (Ritalin IR and Ritalin LA) are not impacted by this discontinuation and will continue to be supplied.
PHARMAC has received clinical advice from our Mental Health Subcommittee that Rubifen SR is the most comparable alternative to Ritalin SR.
The advice is that transitioning from Ritalin SR could appropriately be managed in primary care. The clinical advice also suggested that this could be a good time for prescribers to consider the ongoing therapeutic need of this medicine for their patients.
The supplier has decided to discontinue this product – it was not a decision made by PHARMAC.
If you have questions about the discontinuation of Ritalin SR, contact Novartis on 0800 354 335. If you have questions about funding criteria for 20 mg dose of methylphenidate hydrochloride sustained release you can email enquiry@pharmac.govt.nz or phone 0800 660 050.
12 May 2020 | Guidance for withdrawal from Phenelzine and switching to another antidepressant
The following has been released regarding phenelzine in NZ:
Guidance for switching from phenelzine to another antidepressant [PDF; KB]
24 April 2020 | Urgent message from PHARMAC re discontinuation of phenelzine (Nardil) tablets
PHARMAC has released the following correspondence regarding the discontinuation of phenelzine tablets in New Zealand. Psychiatrists as prescribers may need support transitioning patients from phenezline to alternative treatment.
Read the letter announcing the discontinuation of phenelzine sulphate 15 mg tablets [PDF; 211 KB]
1 November 2019 | New Zealand Transport Agency - Funded brand of Epilepsy medication (Lamotrigine)
The New Zealand Transport Agency has released the following advice about driving, following the change to funded brands of lamotrigine:
"Pharmac has recently announced there will be changes to funded brands of epilepsy medication, effective 1 October 2019.
The Transport Agency’s primary concern is road safety, and while we will not be enforcing a mandatory stand-down period from driving as we do when licence holders undergo a withdrawal of treatment, as a precaution we will be recommending that health practitioners whose patients have or will be transferring brands consider a voluntary stand down from driving during the eight-week early transition period after switching medications, should they have any concerns when considering an individual patient’s medical history and other relevant factors.
Additionally, we encourage anyone with concerns about the potential side effects as a consequence of changing brands to consult with their health practitioner or specialist before continuing to drive. Health professionals are often best placed to make a determination in respect of a person’s driving ability, by considering the patient’s medical history and other relevant factors that may only be known by their health practitioner."