Pharmacies to ration antidepressant medication
Pharmacists are under strict orders to ration a drug used by 78,000 New Zealanders each year to treat depression and anxiety, in an effort to curb the impact of a sudden national shortage of the medication.
On Friday, Pharmac ordered pharmacists across the country to dispense no more than seven days’ worth of fluoxetine at one time – an instruction that will remain in place till the end of February.
Wellington pharmacist Ant Simon would normally dispense 16 boxes of fluoxetine each week. The rationing will mean his Tawa pharmacy will get just two boxes each week, for the same number of patients.
‘‘We’ll be scratching around. We are under the pump already,’’ he said.
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat symptoms of depression, anxiety, and sometimes obsessive compulsive disorder (OCD) and bulimia. Sudden withdrawal or stoppages could lead to heightened states of panic, Simon said.
Switching to another SSRI such as citalopram was an option, but required patients to be weaned off fluoxetine and on to something else – a change GPs and pharmacists did not have the time to carefully manage, Simon said.
Pharmac says it will investigate how a supplier that was meant to provide the drug for another four months failed to better predict demand.
Pharmac is in the process of switching suppliers for fluoxetine.
Existing supplier Viatris had a contract to supply the New Zealand market with its drug Fluox till June 1, when a new supplier, Teva, would take over with ArrowFluoxetine, said Pharmac’s director of operations, Lisa Williams.
But the stock from Viatris ran out much earlier than expected, because demand was ‘‘significantly higher than they anticipated’’, Williams said.
Pharmac was given ‘‘very little’’ warning about the shortage – a matter of days – which was why it could not give pharmacists much warning either, Williams said.
She was confident that the shortage would be sorted within a month, with two shipments of Arrow-Fluoxetine due to arrive in February, but it will take up to two weeks for it to reach the community.
The shortage is expected to affect between 10,000 and 46,000 patients, depending on how many of the 78,000 New Zealanders on fluoxetine were due for a new prescription during February.