Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Epanutin supply problems

The manufacturer of Epanutin®, a brand of phenytoin, has written to healthcare professionals advising of a short term supply problem. Phenytoin is used in the treatment of epilepsy. A copy of the letter (PDF) has been made available by the Pharmaceutical Services Negotiating Committee.

The supply problem is affecting the 25mg, 50mg and 100mg strengths. The 25mg and 50mg strengths are expected to be back in stock by week ending 19th November 2010 with the 100mg strength expected week ending 26th November 2010 although stock imported from Greece is expected at the same time as the lower strengths.

It should be noted that phenytoin is also available in a 100mg tablet but a permanent change to this product would be expensive. The Drug Tariff currently lists 28 tablets at £30.00 compared to £2.83 for 84 capsules.

Action: Clinicians should be aware of this supply shortage. Interim prescriptions for alternative strengths or formulations may be necessary while the supply chain is restocked.

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12 Comments to “Epanutin supply problems”

  1. August 2012
    This supply problem is still ongoing, I have been trying to get my prescription for nearly 3 weeks. I have been given 25 mg to take in place of the unobtainanle 50 mg, but this is so unaccetable- especially as every time I visit the pharmacy they always have someone who doesn't usually work in the branch and doesn't know what the problem is.

    Comment by Di — August 25, 2012 #
    Reply

  2. I have been having difficulty obtaining Phenytoin since November. I Have a 12 month batch prescription with a chemist and so am always ringing the doctor for another prescription so that I can try to find another pharmacy that has these drugs as I cant take my main prescriptions elsewhere. I have 50ml tablets and have been having 25ml as these are the only tabs available. Ihave been taking these for over 35 years and always written on the bottle is 'do NOT stop taking this medicine' I wonder what the legal situation is????

    Comment by Sandra Chattenton — February 1, 2011 #
    Reply

  3. After 2 months still trying to obtain 50mg of Phenytoin. I am not very well controlled so I expect to find my self in hospital,that's what I call false economy. I also take 2 other anticonvulsant drugs and the pharmacy have said these could go as short as the phenytoin. My consultant stated theses are the drugs I need and are not to be changed so where do you go from here.

    Comment by G.Marshall — January 28, 2011 #
    Reply

    1. @G.Marshall,

      I can understand your frustrations but please be aware that the NHS is as much a victim of this shortage as you are. It is the drug company who are at fault for allowing this stock problem to arise. It was my understanding that this supply problem expected to begin resolving by early January this year. Clearly there are still problems. Do you know if your pharmacy has contacted the manufacturer of Epanutin directly? Often, if a pharmacy contacts the manufacturer directly they can access emergency stocks.

      To my knowledge that is no impact on the supply of other anticonvulsant drugs at the current time but this sort of thing does unfortunately happen from time to time.

      Comment by Matthew Robinson — January 28, 2011 #
      Reply

  4. Still our local pharmacy unable to get my husbands quota of epanutin capsules - 350mg daily.
    This month he has endless bottles of phenytoin in liquid form - however my husband these last couple of days has seen an increase in his motor seizures and epileptic pain (which means he having to increase his ClassA painkillers). I used to work for a pharmaceutical production company and if we had got in this situation heads would have rolled. It is not acceptable. Judy Powell

    Comment by Judy Powell — January 24, 2011 #
    Reply

  5. Thanks Matthew. As my doctor can't supply my drugs, I got on the phone to a high street chemist and he said: getting hold of Epanutin is a nightmare, it is rationed to each outlet and the suppliers will not increase the quota, no matter how many epileptics walk through the door - it's like wartime rationing.
    Pfizer (profits up from last year by 71.4%) surely owe our dispensing doctors, suppliers and not least, those of us who depend on the drug, a serious explanation about what has gone wrong and when it is going to be rectified.

    Comment by A.Barson — January 15, 2011 #
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  6. …and still my doctor can't get hold of 50mg phenytoin and I run out in three days. Is it too silly to ask what we are supposed to do…?

    Comment by A.Barson — January 14, 2011 #
    Reply

    1. @A.Barson,

      Unless you have a dispensing doctor you should be talking urgently with your pharmacist (not your doctor) about finding a source that can supply your medication. They may be able to find some sitting on a shelf in another pharmacy, locate some in a wholesaler or approach a manufacturer direct for urgent supply.

      Comment by Matthew Robinson — January 14, 2011 #
      Reply

  7. I suffer from epilepsy, I am not happy with this distribution problem.
    My Gp was not pleased when I went back to him with half of what he had prescibe for me.
    The pharmacy had told me that they could not supply me with the rest of the medication.
    I take 450mg of phenytoin, or Epanutin, and have
    done so for a good thirty years or so.

    Comment by David Borg — January 10, 2011 #
    Reply

  8. It is now 8 january, there is still a problem, my pharmacy has said they are only allowed 5 pots of 28 capsules (50mg) per wk. So far I've managed by using my "spare" stock, but running out fast.
    This must be causing major problems for many with epilepsy.

    Comment by Di — January 8, 2011 #
    Reply

  9. Is it not somewhat strange that the reason given for the supply problem is the lack of a Braille information leaflet that is a regulatory requirement - however stocks from Greece have been imported and released with specially printed information leaflets in English (but no Braille)? Why not just release the English medication if Greek medication has to have an English insert printed?

    Comment by Richard — November 29, 2010 #
    Reply

  10. This is absolute disgrace,it is now 26/11/10 and there are no 50mg tablets left in my area. This company surely cant expect patients to completely change their medication ? we're not talking about headache pills here, this has very serious implications -- but hey, it's only epileptics eh !!

    Comment by Collette Gammond — November 26, 2010 #
    Reply

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