A guide to drug shortages and their potential alternatives for healthcare professionals in primary care

1. Potential Drug Shortages and their Alternatives
Adalat 5mg- amlodipine
Adalat la 20- nifedipine mr 10mg bd
Angeliq- kliovance
Betnesol n- otomize/sofraxex
Betamethasone soluble tabs- hydrocortisone buccal tabs
Betnovate RD- audovate RD
Bezafibrate 200mg- bezafibrate 400 xl
Caramet 25/100- half sinemet 25/100
Cilest-Cilique/Lizinna
Clomethiazole-oxazepam/lorazepam/promethazine/zopiclone
Coracten xl 30mg- amlodipine/Coracten sr bd/ nifedipress mr 10mg bd
Creon-Pancrease/Nutrizym/Pancrex
Dalacin lotion- Dalacin solution/zineryt/epiduo/duac
Diamorphine- morphine
Doxadura xl- generic or normal release
Duac-epiduo
Elleste solo (estradiol1mg)- progynova/zumenon
Elleste solo mx 40mcg- evorel 50mcg
Elleste duet 1mg- novofem
Elleste duet 2mg- femoston 1/10 or 2/10
Elleste duet conti- kilofem/femoston conti
Epilim tabs- combine different epilim strengths/ generic/epilim liquid
Epilim chrono tabs- epilim chrono sachets/normal epilim
Epipen- jext
Femseven conti- evorel conti
Femseven sequi- evorel sequi
Femseven-evorel/ estraderm
Forceval soluble-ketovite
Fragmin-dalteparin
Fucithalimic eye drops-generic/ciloxin/chloramphenicol
Furosemide- bumetanide/torasemide
Hux D3-osteocaps (vegetarian)
Indomethacin- Celecoxib/naproxen/meloxocan
Iopidine-brimonide
Ky jelly- yes gel
Lacri lube- vita pos/xalin night
Labetolol- nifedipine
Loestrin 20- gedarel 20/150 or cerelle
Lorazepam 1mg-temazepam 10mg/Lormetazepam
Lodoxamide- sodium cromoglicate
Loprazolam- lorazepam
Maxidex-eythalm/dexafree/dropodex
Medihoney- conotrane/cavilon
Menadiol-phytomenadione
Metoprolol- bisoprolol
Montelukast 10mg- give two 5mg
Naseptin- bactriban nasal/mupirocin
Phyllocontin- uniphyllin/phyllocontin forte

2. Protopic-ellidel
Propranolol-busoirone (anxiety)
Predforte- give 10ml pack
Premique low dose-kliovance/indivina
Questran- light version/colesevelam/Colestid
Quinine Sulfate 300mg-bisulphate 300mg
Selsun- t gel/capsal/nizoral
Skinoren-finacea
Slow k- sando k/Kay cee
Strontium-raloxifene/denosumab/teriparatide
Tizanidine-baclofen/methocarbanol
Trimovate- fusidic acid and betnovate/timodine
Valsartan-losartan/candesartan
Vertab 240mg- generic/securon
Zacin cream-axasin cream
Zovirax eye ointment-Ganciclovir gel
Process for selecting alternative
1) Have you looked at all suppliers- aah, alliance sigma,phoenix,lexon…
2) Is there an availability date?
3) Are there other brands?
4) Are there other forms eg. Caps/tabs?
5) Is it a narrow therapeutic index drug/initiated by specialist?