There is just two weeks’ supply of anti-anxiety medication lorazepam left in New Zealand, as stock is being restricted due to supply chain issues.
On Friday, Pharmac announced that supply of 1mg lorazepam tablets, generally used short-term to manage moderate to severe anxiety and sleep problems (branded as Ativan), was disrupted due to “logistics challenges” and will not be resupplied until early-to-mid August.
“This means the shortage will affect those who need a prescription dispensed within the next two to four weeks,” Pharmac’s director of operations Lisa Williams said.
Pharmac’s contract with the supplier, Aspen, requires it to hold at least two months’ supply of any medicine it supplies to New Zealand. Pharmac will be investigating why this obligation has not been met.
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There is no direct chemical substitute available for the medicine, however Pharmac has been working “to help ensure the remaining stock is distributed as fairly as possible”.
On Thursday, the drug buying agency advised pharmacies that they should only dispense a week’s supply of the 1mg dose to patients, to ensure “equitable distribution” among patients.
This rule would be in place until August 31.
Lorazepam is a benzodiazepine, and should only be prescribed for short periods: about two to four weeks at a time.
Pharmac’s expert clinical advisors have reinforced the importance of continuity of supply for this “important” medicine.
There are 0.5mg and 2.5mg doses of the medicine available in New Zealand.
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Some clinicians may consider transitioning patients to half a 2.5mg tablet – which is scored, to make halving easier – however clinical judgment would be needed, as this would increase a person’s dose from 1mg to 1.25mg.
Doing so would require a new prescription, Williams said.
“We know supply disruptions can be distressing for people,” she said.
Pharmac was working to secure an alternative supply of the 1mg lorazepam. Its clinical advisors informed that there were “alternative” treatments, but transitioning people from lorazepam to something else would require a clinicians’ involvement.
“People will need to speak to their GPs, who can advise them on the best possible option for them.”
“We know this is not ideal with an already stretched health system, but it’s important we alert clinicians, pharmacists, and the public about supply issues as soon as we are able,” Williams said.