Shortage of Quetiapine 150mg, 200mg and 300mg Tablets
The Department of Health and Social Care (DHSC) and NHS England Medicines Supply Teams have reported a shortage of quetiapine 150mg, 200mg, and 300mg tablets. This article summarises the key points of the notification and offers guidance for healthcare providers to manage this supply disruption effectively.
Introduction
Quetiapine is an antipsychotic medication widely used for treating schizophrenia, bipolar disorder, and major depressive episodes. Due to the current shortage of certain dosages, healthcare providers need to consider alternative strategies to ensure continuous and effective treatment for patients.
Key Points of the Shortage
- Affected Dosages: Quetiapine 150mg, 200mg, and 300mg tablets are in limited supply.
- Impact: The shortage is categorised as a medium impact (Tier 2), necessitating more intense management options but considered safe for implementation at the sub-regional level.
Actions for Healthcare Providers
- Avoid New Prescriptions: Clinicians are advised not to initiate new patients on the affected dosages until the supply issue is resolved.
- Alternative Prescriptions:
- Lower Strength Tablets: Prescribe quetiapine 25mg, 50mg, or 100mg tablets, using the largest available strength to meet the required dose.
- Quetiapine XL Prolonged-Release Tablets: Consider prescribing quetiapine XL tablets, adjusting the dosing frequency to once daily. Patients should be counselled on the change in formulation and dosing regimen and instructed to take the dose without food.
- Oral Solution: As a last resort, quetiapine 20mg/ml oral solution may be prescribed, ensuring the patient has no intolerance to the excipients.
- Consult Specialists: If none of the alternative options are suitable, seek advice from specialists on alternative management strategies.
Alternative Options
- Available Strengths: Quetiapine 25mg, 50mg, and 100mg tablets remain available.
- Quetiapine XL Tablets: These include strengths of 50mg, 150mg, 200mg, 300mg, 400mg, and 600mg.
- Oral Suspension: Quetiapine 20mg/ml oral suspension is also available.
Considerations and Background Information
- Licenced Indications: Quetiapine is licensed for the treatment of schizophrenia, bipolar disorder, and the prevention of manic or depressed episodes in bipolar disorder.
- Administration:
- Immediate Release (IR): Taken twice daily with or without food, except in major depressive episodes where it is taken once daily at bedtime.
- Prolonged Release (XL): Taken once daily without food, at least one hour before a meal.
- Switching from IR to XL: The total daily dose is taken once daily, with individual dosage adjustments as necessary.
Supply Summary
- Limited Supplies: The shortage is expected to persist until 30 August 2024.
Impact Assessment
- Medium Impact (Tier 2): Requires more intense management options such as using therapeutic alternatives, unlicensed imports, or alternative strengths or formulations. These actions are considered safe to implement at the sub-regional level without further escalation.
Conclusion
The shortage of quetiapine 150mg, 200mg, and 300mg tablets requires healthcare providers to consider alternative dosing strategies and formulations. By following the DHSC and NHS England guidance, clinicians can ensure patients continue to receive effective treatment without interruption.
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