Update Diamorphine Supply Issue

Dear colleagues

Please see the following update from the Department of Health and Social Care (DHSC), regarding the diamorphine supply issue, which we informed you of last month:

The DHSC and NHS England have since been working with Accord and their supplier in Germany and the manufacture of diamorphine 5mg and 10mg injection will soon resume with an anticipated resupply date of beginning of September 2018. DHSC and NHSE have also been working with the remaining supplier, Wockhardt, to support the supply issue and they have been able to increase their production of diamorphine 5mg and 10mg but are unable to support the entire market in July and August. A management plan has been developed to manage the supply issue during July and August:

Management plan from 1st July 2018:

Primary care and drug misuse centres will be able to continue to order diamorphine in line with historical demand.

Secondary care will have access to restricted supplies of diamorphine

Recommended Local Action- Primary care and drug misuse centres

Although you will be able to access diamorphine as per historical demand, we would encourage prescribers to be aware of the supply issues and reduce prescribing where appropriate

Please order responsibly during this time, in line with historical demand and do not stock pile to avoid lengthening the stock out period.

In the case that diamorphine cannot be accessed, please refer to the clinical guidance issued by UKMI which provides more information on suggested alternatives to diamorphine: www.sps.nhs.uk/articles/shortage-of-diamorphine-5mg-10mg/ . The first-choice is morphine which is given in detail in this link. If you require clinical guidance locally – please liaise with secondary care prescribing partners in substance misuse services or pain specialist services

Further information which you may wish to review include the Patient Safety Alert on high dose morphine and diamorphine www.nrls.npsa.nhs.uk/resources/?entryid45=59803

Distribution Arrangements (From 1st July)

Diamorphine 5mg and 10mg will only be available to order from Alliance. No minimum surcharges will be levied

Morphine 10mg injection (Martindale) available to order from AAH only.

Diamorphine 30mg injection (Wockhardt), diamorphine 100mg (Accord) and diamorphine 500mg (Accord and Wockhardt) – usual wholesalers.

For further information on ordering processes please contact:

Alliance 0330 1000 448 / customerservice@alliance-healthcare.co.uk

AAH: 0344 561 8899

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Updated on 21 June 2018