SSPs issued for Fluoxetine: Urgent actions required by pharmacy teams


SSPs issued for Fluoxetine: Urgent actions required by pharmacy teams

October 3, 2019

In response to significant ongoing disruption to the supply of Fluoxetine capsules, the first Serious Shortage Protocols (SSPs) have been issued by the Department of Health and Social Care (DHSC).

Three SSPs have been authorised by the Secretary of State to help manage the supply of some formulations of Fluoxetine and to try to ensure that fewer patients have to return to their prescriber. Developed by clinicians, the protocols provide pharmacists with procedures to follow in providing a suitable alternative product. Pharmacist must also exercise their professional judgement to ensure the alternative product is suitable for the patient.

Whilst 10mg, 30mg, and 40mg capsules of Fluoxetine are fairly low volume lines, DHSC believes the disruption to supply has reached a level that requires intervention. PSNC has been informed by DHSC that the 20mg capsules – the most commonly prescribed formulation – are in good supply.

Community pharmacy contractors and their teams are asked to read the below SSP documents and to implement the protocols with immediate effect on Thursday 3rd October.

SSP01: Fluoxetine 10mg capsuleswithdrawn 25/10/2019

SSP02: Fluoxetine 30mg capsulesextended

SSP03: Fluoxetine 40mg capsulesextended

The SSPs may be amended or revoked at any time but currently expires at the end of October – PSNC will update contractors on any changes.

All community pharmacies will receive an email to their shared NHSmail account informing them of these SSPs.

The SSP recommendations

The SSPs provide that an alternative strength and/or formulation of Fluoxetine may be supplied against prescriptions for 10mg, 30mg or 40mg capsules as follows:

  1. Fluoxetine 10mg capsules -> Fluoxetine 10mg tablets or fluoxetine 20mg/5ml solution or fluoxetine 20mg/5ml oral solution sugar free (SF)
  2. Fluoxetine 30mg capsules -> Fluoxetine 10mg tablets and fluoxetine 20mg capsules
  3. Fluoxetine 40mg capsules -> Fluoxetine 20mg capsules

Support in implementing the SSPs

The following resources have been developed to support pharmacy teams in using these protocols.

PSNC Briefing 046/19: Serious Shortage Protocols (SSPs): SSP01, SSP02 & SSP03 – Fluoxetine 10mg/30mg/40mg capsules

Fluoxetine supporting endorsement guidance

Serious Shortage Protocols Operational Guidance

Serious Shortage Protocols Questions & Answers

PSNC’s Serious Shortage Protocols (SSPs) Endorsing Factsheet

PSNC Briefing 023/19: Serious Shortage Protocols – A guide for community pharmacy teams

PSNC statement

PSNC Director of Operations and Support, Gordon Hockey, said:

“With the introduction of these first SSPs, community pharmacists have a new way in which they can continue to play their invaluable role in helping patients to obtain the medicines they need. The SSPs should allow some patients to obtain their prescribed medicines in a quicker timeframe than might otherwise have been possible.

The SSPs contain much guidance to support pharmacists in arriving at a professional decision on supply to the patient. While we recognise that implementing SSPs will require a new way of working for pharmacies, we see this as a positive step in giving the sector more freedom to make minor changes to the treatment provided without needing to await the individual doctor’s approval.”

Background information on SSPs

Further information on what SSPs are and when they may be used is available via the links below.

Serious Shortage Protocols (SSPs) on-demand webinar

Serious Shortage Protocols (SSPs) webpage

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