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You are here: News » News Archive 2009 » Fluoxetine above drug tariff; AAH fuel surcharge
Fluoxetine above drug tariff; AAH fuel surcharge
News in Brief
Dr Allan Tennant reports
5th of November 2009
Fluoxetine purchase price above drug tariff
Fluoxetine 20mg capsules drug tariff price is £1.15. We are seeing prices as high as £2 a pack. Normally reliable suppliers are unable to obtain stock. If you can get hold of product the cheapest price today is £1.44. October prescriptions should have been endorsed NCSO and we predict that this will also happen for November scripts.
Fluoxetine is not a drug that can be swapped for another SSRI. After stopping fluoxetine, an alternative SSRI should not be started until 4-7 days later, as fluoxetine has a long half-life and active metabolites. This is in order to avoid serotonin syndrome, which occurs when combinations of serotonergic antidepressants are prescribed. Symptoms can include confusion, delirium, shivering, sweating, changes in blood pressure, and myoclonus. The patient can be very distressed.
Patients can also suffer withdrawl effects of increased anxiety, sleep disturbance, GI disturbance, headache, dizziness, fatigue, flu like symptoms and sweating when stopping SSRIs suddenly.
There are multiple reasons to explain generic drug shortages.
- Substrate shortages
- Manufacturing problems
- Stock piling
We have noticed some other high volume generic products prices are rising sharply including Ramipril 10mg capsules and Omeprazole 20mg capsules and the latter is seeing limits in order volume.
It is our impression that low price products are also rising in price.
AAH fuel surcharge
AAH will reintroduce a fuel surcharge of £2.35 per site per month from the 1st of December unless fuel prices fall.
VAT reminder
I am sure all readers know that VAT will go back up to 17.5% on the 1st of January 2010.