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Phenytoin Supply Disruption Alert

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Drug supply issues are an interesting use-case for OpenPrescribing. Here we will talk about a recent example.

What is the problem?

Last week the Department of Health and Social Care issued a “Supply Disruption Alert” for Epanutin (phenytoin) 30mg/5ml oral suspension: Pfizer, the manufacturer, will be out of stock of this product from the week commencing 29th October (today) until early December 2018. This means people currently taking Epanutin (phenytoin) 30mg/5ml oral suspension may need to be prescribed a different product.

Why is it important?

Phenytoin is a medicine that is generally used to prevent seizures in people with epilepsy. The Medicines and Healthcare products Regulatory Agency (MHRA) classify medicines for epilepsy into three different categories and phenytoin as a Category 1 antiepileptic drug. This means doctors are advised to ensure that their patient is maintained on a specific manufacturer’s product. This is important as phenytoin has a “narrow therapeutic index” which means that a person is at risk of seizures if their product is changed without medical supervision.

The alert gives very clear instructions to doctors, patients and other healthcare professionals on how to manage this situation: advice on switching, the availability of alternative products and when to access specialist advice. The alert also advises GPs to identify all patients currently prescribed Epanutin (phenytoin) 30mg/5ml oral suspension and make early contact with the patient or parent/carer.

How can OpenPrescribing help?

At OpenPrescribing we’re making it easier for GPs, managers and everyone to explore prescribing data out in the open — supporting safer, more efficient prescribing. To review the prescribing of Epanutin (phenytoin) 30mg/5ml oral suspension for your practice or CCG you can use our Analyse page:

  • Click here.
  • On the “highlighting” button, select your CCG or practice (circled in yellow below)
  • Press the “Show me the data!” button
  • If your prescribing is zero for the latest month, try scrolling back the months to see if you have prescribed it recently (circled in blue below).

Note: Our data covers the last five years and data is released by the with a lag of 6-8 weeks, so it will not show up any recently initiated prescriptions.

Some patients may be receiving this medicine from a prescription written generically (i.e. phenytoin). You can find all prescriptions for generic phenytoin liquid by clicking here and following the steps above.

Anything else?

Yes. At OpenPrescribing we are ready and willing to work with organisations to assist them to use data and tools, to support front-line clinicians implement the latest evidence, guidance and important alerts such as this one. Please get in touch at feedback@openprescribing.net if you think this might be your organisation.