Lorazepam 4mg/mL injection UK national shortage

28th December 2010

There is a national shortage of lorazepam injection 4mg/mL (Ativan, Pfizer) in the UK. This is due to an unexpected manufacturing issue, and is not expected to be resolved until late in 2011.

Full details of the manufacturing problem and phone numbers for supply queries and medical queries can be obtained from the letter sent to the Department of Health from Pfizer, which can be downloaded from the link below.

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NPSA Rapid Response Report on syringe drivers

22nd December 2010

The UK National Patient Safety Agency (NPSA) has issued a Rapid Response Report (RRR) on the safer use of ambulatory syringe drivers. The report warns of the risk of errors using older types of ambulatory syringe drivers that have rate settings in millimetres (mm) of syringe plunger travel rather than in millilitres (mL) and other issues that have led to eight deaths (four in 2009) and 167 non-fatal error reports between 2005 and 2010.

The NPSA recommend a coordinated approach and timescale to change over to ambulatory syringe drivers with additional safety features to minimise the additional risks of introducing the safer equipment. All organisations in the NHS and independent sector should (taken directly from source):

1. Develop a purchasing for safety initiative that considers the following safety features before ambulatory syringe drivers are purchased:
a) rate settings in millilitres (mL) per hour;
b) mechanisms to stop infusion if the syringe is not properly and securely fitted;
c) alarms that activate if the syringe is removed before the infusion is stopped;
d) lock-box covers and/or lock out controlled by password;
e) provision of internal log memory to record all pump events.

2. Agree an end date to complete the transition between existing ambulatory syringe drivers and ambulatory syringe drivers with additional safety features (as soon as locally feasible, and within five years of this RRR).

3. Take steps to reduce the risks of rate errors while older designs of ambulatory syringe drivers remain in use, based on a locally developed risk reduction plan which may include: raising awareness, providing information to support users with rate setting, and using lock-boxes.

4. Take steps to reduce the risks during any transition period when both types of design are in use, including:
a) reviewing and updating policies and protocols to include the safe operation of all designs of ambulatory syringe driver in local use;
b) revising user training programmes to include the safe operation of all designs of ambulatory syringe driver in local use.

The deadline for the above actions to be completed is 16 December 2011. The RRR and further information can be downloaded from the links below.

Rapid Response Report RRR019
RRR019 supporting information
NPSA website

MHRA batch recall: Gabapentin 300mg capsules (Teva)

22nd December 2010

Teva UK Ltd are recalling all remaining stock of the following batches of gabapentin 300mg capsules due to the discovery of a small number of capsules with low fill weights. The affected batches are: 003784, 003795, 003796, 003798, (pack size 100, first distributed in August 2010, expiry June 2012). All remaining stock should be quarantined and returned to the supplier for credit. For enquiries relating to stock returns call Teva UK Ltd (0800 590502). For further information see the MHRA recall notice which can be downloaded from below.

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Annual evidence update on complementary and alternative medicine for lower back pain

16th December 2010

The UK NHS Evidence complementary and alternative medicine website (formerly a specialist section of National Library for Health) has produced the 4th annual update of the evidence on complementary and alternative medicine for lower back pain.

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Annual evidence update on chronic lung disease

16th December 2010

The UK NHS Evidence supportive and palliative care section (formerly National Library for Health) has produced an annual update of the evidence in chronic lung disease focusing on the treatment of cough and dyspnoea.

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Clarifying dexamethasone prescribing

1st December 2010

The new BNF (60) now recommends prescribing of dexamethasone injection as dexamethasone base. This follows recent changes to the labelling of both UK dexamethasone injection products (Organon product, 2003 and Hospira product June 2010) in line with guidance from the UK MHRA and NPSA.

In order to clarify the label changes and highlight the potential for confusion when swapping between products, we have put together a palliativedrugs.com fact sheet which can be downloaded from the link below.

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