Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Venlafaxine Shortage

The manufacturer of venlafaxine (Efexor)® has written to clinicians to inform them of stock shortages.

The letter from the Medical Director states that only the 75mg tablets are affected and that they are working urgently to resolve the manufacturing difficulties and they provide a website address for weekly updates. This website suggests that the problems will begin to resolve in two months.

As previously detailed, the MHRA have suggested that this drug is only initiated by specialists or GPs with a special interest in mental health. Additionally, venlafaxine should not be used in any patient with heart disease, electrolyte imbalance or hypertension.

Action: The MHRA advice suggests that this drug has a limited place in therapy. The current stock shortage provides the ideal opportunity to review current patients with a view to stopping or changing to a different antidepressant.

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13 Comments to “Venlafaxine Shortage”

  1. I've got same problem, but my pharmacist contacted me to let me know.
    This month she's issued 2 x 37.5mg twice a day rather than 1 x 75mg.

    She's contacted local health board for advice.
    Apparently there is a licencing issue. She's been chasing it. They say it should be resolved in a month.
    SR are available. But if everyone swaps over there will be an issue with these as well.
    I phoned a number of local pharmacies, all were having same issue

    However Boots have them. So worth ringing your local Boots to see if the have them in stock.

    Comment by Judith Bridges — December 4, 2017 #
    Reply

  2. I take Venlafaxine, usually 75mg twice a day. When I asked the pharmacist why I couldn't get my usual medication dose, she explained that the manufacturer sold them to the wholesaler who was then selling them to other countries for more money instead of the usual pharmacies like mine. She said that is why they are short. Is that true or not? It's only what I was told.

    Comment by Christopher Rudrum — November 22, 2017 #
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    1. @Christopher

      Sad to say but this could quite possibly be true. And while it makes life very difficult for us at the moment, no one really bothered too much when the UK were buying medicines cheaply from mainland Europe and leaving other countries with shortages. Something should be done to address this at European level however I suspect 'Brexit' is the main priority at the moment.

      Comment by Matthew Robinson — November 23, 2017 #
      Reply

  3. I rang my pharmacy to find out if I could pick up my script for my 37.5mg of which I take 2 per day, to be told that there is a shortage, I said OK what do I do and the lady said, "we cant get them". So again I said OK what do I do as I need these, she got another person to the phone who told me to see my doctor and get a different dose as she cannot change my dosage. I informed her I only had a few left so she said she had enough to keep me going for a few days but after that I must see my GP. Whats going wrong when no one informs you that the medication you have been taking for 10 years is no longer available, but they only tell you when you ring them. I am so fed up with people not doing their jobs properly and having no care or when dealing with the public?

    Comment by Fran — November 15, 2017 #
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  4. I am also affected by this - it is just ridiculous. Venlafaxine is the only anti-depressant that has worked for me & now I am learning that this supply problem could go on for months. And it sounds as if it could be discontinued as this report says it is an ideal opportunity to change patients to other antidepressants.

    Comment by Dianne Pallett — November 13, 2017 #
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  5. Same problem - not available - no warning, no advice - one tablet left!
    I did however manage to get some from another store - but I thought I was going to suffer with withdrawals and severe headaches!
    Not happy - I'm on a high dose!!
    It panicked me - why has this happened?

    Comment by Gail Johnson — November 10, 2017 #
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    1. @Gail

      I can only presume some global shortage of a key ingredient in the manufacture process, interesting though that the higher cost modified release products are currently unaffected and remain in supply.

      Comment by Matthew Robinson — November 10, 2017 #
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  6. I had issues last month as I am on 75mg x 2 per day so was given 37.5mg to take 2x2. This month when I went to pharmacist I was told she only had delayed release but needed a specific script to issue those. I have been on numerous anti depressants and venlafaxine are the only ones that work for me. I have been using the same surgery and pharmacy for years so cannot believe the pharmacy could not phone me to advise the lack of tabs when they have a record of all the medications I am on and have been on. I have now been without the relevant meds since Thursday and have to make an emergency appointment with my doctor on Monday morning.

    Comment by Andy — November 4, 2017 #
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  7. This has just happened to me too. I am so angry that nobody has called from the surgery to warn me of this problem. There will be no more venlafaxine until February according to my pharmacy. I have 1 days supply left and am getting a prescription for the modified release tablets faxed over to the pharmacy today via 111, as the surgery is closed. I am on 150mg twice a day, which is near the maximum dose prescribed. I've been on this drug for near on 20 years and I am freaking out! I have tried to come off it on numerous occasions and the withdrawal effects are horrendous - nausea, vomiting, brain zaps, huge mood changes - usually mania first. To even have to be on a different medication for the next few months is going to have a massive impact on my wellbeing. Some people will probably have suicidal moods because of changes. Moods in Bipolar Disorder are massively affected by these medications. I am freaking out and extremely angry.

    Comment by Rachel — November 4, 2017 #
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    1. @Rachel

      Im please to hear that NHS111 have managed to arrange a prescription for you and sent it to your pharmacy. Perhaps your surgery are not aware there is a problem and I have only today learned from you that this issue is likely to last until February.

      It is a sad fact that pharmacies and surgeries don't communicate better. Surgeries provide the scripts, pharmacies order and supply medicines. The pharmacies seem to just send people back to surgeries when they can't get an item. In my experience they send people back far too easily (i.e. when items are in stock with the manufacturer for example), they don't tell the surgery what they can get when an item is genuinely out of supply and they don't inform surgeries how long the issue is likely to be around for.

      In the ideal world of my imagination surgeries would be much better informed of supply shortages and pharmacies would be in a position to simply supply reasonable alternatives without the delay of having to get another prescription. Sadly, these ideas remain very much in my imagining.

      Comment by Matthew Robinson — November 4, 2017 #
      Reply

  8. I've been on Venlafaxine for 5 years with Quietiapine and have waited 3 days to be told there is none and I don't have any left. My GP is refusing to talk to me and advised I talk to my pharmacist for an alternative! How can that be?! I have missed doses before and the withdrawal effects for me are immediate and I'm worried sick now because I'll have to change meds without tritation!

    Comment by Amanda — October 23, 2017 #
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    1. @Amanda

      Sadly this is something I see first hand most weeks. Pharmacies aware of what items are in supply and unfortunately, all too often, doctors are asked to supply an alternative without any additional detail being supplied. So they prescribe an alternative in good faith only for that to be out of stock too. The other thing that tends to happen is patients are told an item is out of stock when a telephone call to the manufacturer says otherwise.

      Rather than simply directing you back to the GP, perhaps if your pharmacist identified a reasonable alternative for your GP to prescribe, something that they have in stock or can easily obtain, and then requested that for you your GP might feel more inclined to write a different prescription.

      Comment by Matthew Robinson — October 23, 2017 #
      Reply

    2. I had this problem today when I went to collect my prescription, I am on the exact same medication as yourself 1x75mg in the morning and 1x75mg at night, I had 5 trips to the doctors and pharmacy passing on messages trying to get a solution to this, eventually the chemist had 150mg of slow release venlafaxine which I used to be on about 6 months ago until they changed it to 2x75mg a day. It was alot of hassle but eventually the doctor amended my prescription to the slow release tablets for this month. I hope you got your medicine sorted out but I think it's a disgrace to leave someone with no medication and for your doctor not to help. I would put a complaint in against your surgery. I am dreading next month as I have a feeling its not going to be sorted. Kerry x

      Comment by Kerry — November 3, 2017 #
      Reply

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