Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Fluphenazine decanoate discontinued

The manufacturer of fluphenazine decanoate (Modecate®) injection has written to healthcare professionals advising that this product will be discontinued by the end of 2018.

The letter details unpredictable supplies of the active ingredient from the single global manufacturer as the reason for this decision. It is noted that this decision is not due to any safety concerns. Both injection strengths (25mg/ml and 100mg/ml) are being discontinued with manufacturing ceasing in mid-2018 with supplies in the United Kingdom expected to run out by the end of 2018.

Action: Clinicians should be aware of this product being discontinued. It would be prudent to run clinical system searches to identify any patients who are currently prescribed this product to allow a review and arrangements made to identify a suitable alternative.

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22 Comments to “Fluphenazine decanoate discontinued”

  1. My daughter had been on Modecate for years. In June she decided to switch to Depixol, the suggested alternative, before she was forced to. She stopped her fortnightly injections in early June and without starting her new treatment she relapsed in late July, was sectioned and is now in hospital.
    The Ministry of Health should be under a police investigation for it's failure to provide a procedure for safely switching from one medication to another.
    This failure has led to untold suffering and they should be held accountable.

    Comment by John Hobbs — August 6, 2018 #
    Reply

    1. @John,

      I've sad to hear about your daughter's relapse. Do you know why there was a delay in starting the Depixol? Safe transition and choice of the switch product will fall to local mental health services. I wonder why they did not start the new treatment.

      Comment by Matthew Robinson — August 6, 2018 #
      Reply

      1. It is sad but the NHS is above the law.

        I am up to my neck in futile requests for help from them.
        My previously normal grandson 16, non-verbal and severely autistic , can in my opinion, only be helped by the formation of a National Database for Autism and Associated Conditions, designed to split the Autistic Spectrum into subsets which could then be researched and appropriate therapies applied.
        They are desperate not to know and leave parents and families to cope with the horrendous behaviours these people display as they try to relieve the agony they are in.

        Comment by John Hobbs — August 6, 2018 #
        Reply

  2. I've been on modecate for 43 years and makes me very stable. I have tried amisulpride but after 6 years on that my stomach lining was damaged. I can't believe that they are discontinuing modecate - shame shame shame.

    Comment by Peter Fox — July 31, 2018 #
    Reply

  3. My brother is 73 years old he has been on fluphenazine injections for fifty years with no problems now they have stopped them. He's off the planet again and in hospital with a fractured leg after being hit buy a car. I don't think there's a shortage of schizophrenics in this world why stop manufacturing the drug? All I can say is stuff the pharmaceutical company.

    Comment by John — June 20, 2018 #
    Reply

    1. @John,

      There are other options, it seems bizarre that his treatment was stopped under medical supervision and nothing was given in place or no plan was made to monitor him.

      Comment by Matthew Robinson — June 20, 2018 #
      Reply

  4. I have been on Modecate successfully for more than 3 decades. Could you please recommend a suitable substitute with the same results as Modecate (or is there a possibility that this may come back on the market?)
    I live in South Africa, where this product seems no longer available.
    Would appreciate your advice, thanks.

    Comment by Samantha Mckune — June 13, 2018 #
    Reply

    1. @Samantha,

      There are lots of options, you are best seeking to a doctor locally though as what is available varies by region and some options may not be suitable for you based on your medical history.

      Comment by Matthew Robinson — June 20, 2018 #
      Reply

  5. My mother has recently been taken off modecate injections after being on them for 40 years. Following a violent incident at home she has been hospitalised and may never get home again. She is in her 70s. In my view it is unethical to remove the only effective drug (in our experience) for the treatment of severe Schizophrenia with no replacement having been developed. I have written to the manufacturer Sanofi and suggest you all consider doing the same. I wish each of you all the best in dealing with a terrible situation.

    Comment by Margo — June 11, 2018 #
    Reply

    1. @Margo,

      I sympathise with the stressful situation you and your family are in, but it's not really in Sanofi's control. They buy the raw ingredient from a single manufacturer, the only manufacturer in the world, and they cannot guarantee that they will get adequate and timely supplies.

      Although your current situation is far from ideal, it has to be better planning the withdrawal and switch over rather that it going randomly out of supply frequently, something that sounds like it was a significant risk in the future.

      Comment by Matthew Robinson — June 11, 2018 #
      Reply

    2. Will Fluphenazine in the tablet form still be available from our drug stores in North America?

      Comment by Long Term Fluphenazine User — July 7, 2018 #
      Reply

      1. @Long Term Fluphenazine User,

        From searching the internet it certainly seems to be currently available in tablet from in North America. However, you might get a better answer asking in your usual pharmacy.

        Comment by Matthew Robinson — July 7, 2018 #
        Reply

  6. My brother has suffered from schizophrenia for years and his injections were just stopped with no warning, he is now in a hell of a state, I am very worried about him.

    Comment by E Lee — May 15, 2018 #
    Reply

    1. My husband has been on modecate since 1982. We are buying it from out of the country.
      But now under mental health we are getting it free for 1 year as this is the only drug along with zyprexa and cogentin and tofranil that keep him stable as no other drugs work.

      Comment by Maureenandjohnmurray2508@gmail.com — June 10, 2018 #
      Reply

  7. Discontinuing effective mediation for some people is inhumane.

    Comment by Christine — April 15, 2018 #
    Reply

    1. @Christine,

      There are alternatives available, some of which are generally considered to be better treatments. As the popularity of a medicine declines, who should be responsible for keeping it available when it becomes economically nonviable to produce for companies that need to make a profit?

      Comment by Matthew Robinson — April 16, 2018 #
      Reply

  8. Very irresponsible for discontinuing this.

    Comment by L — April 11, 2018 #
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  9. Absolutely agree with the above!
    Seems like the NHS & drug companies do not fear being old or mental! What goes round comes back round! Playing with lives, getting rid of old vulnerable people to cut costs is so evil. May God bring these people to sense.

    Comment by Justice — November 22, 2017 #
    Reply

    1. @Justice

      While I can't speak for the drug companies having never worked for them, I can speak for the NHS and unfortunately this is beyond our control. We are usually just as frustrated as our patients when an effective drug is removed from the market when there are no safety concerns prompting the withdrawal. Sadly, pharmaceuticals are product of business, and when the business deems that it is no longer commercially viable to make a product there is nothing anyone can do to stop them. No one could stop a car maker from producing a model in it's line up.

      On a more positive note, it does seem that this medication remains, for the time being at least, widely available.

      Comment by Matthew Robinson — November 23, 2017 #
      Reply

  10. My son has been given this medication in a form of injection every two weeks for Schizophrenia. I want to know what other medications that are safe to use beside this fluphenazine. This is outrageous how the pharmaceutical companies are getting richer and the government is allowing this to happen. Something needs to be done.

    Comment by Esther M Denis — November 10, 2017 #
    Reply

  11. Why is this product discontinued?

    Comment by Kathy DeLuca — September 22, 2017 #
    Reply

  12. God help people with Schizophrenia whom have been on Modecate most of their lives.
    My mother had been on it for over 60 years until a new consultant misdiagnosed her as having full blown dementia around 12 years ago. We since proved the misdiagnosis but they never put her back on the Modecate. The alternatives have not worked for her and her life has been hell ever since. So people beware, (I am not scare mongering here) you so need to be prepared for this. I still think there is so much more to this than the public are being told. I just can't help feeling we are being fed a load of nonsense. Schizophrenia not treated correctly can kill you. All of the alternative medications carry a risk of sudden death printed in the leaflets. In my opinion, this is about thinning the population down to unburden the grossly overloaded NHS, the mentally disabled being the most vulnerable and easiest of targets. I am disgusted to say the least.

    Comment by Alan Anderson — September 21, 2017 #
    Reply

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