PSNC has issued guidance around prescribing phenytoin and prescription endorsements relating to the shortage of Phenytoin 50mg Infatabs.
A shortage in availability of the UK licensed product was announced last month, with the Medicines and Healthcare Products Regulatory Agency (MHRA) allowing Pfizer to import stock of Dilantin 50mg Infatabs (phenytoin base) from Canada.
Where a prescription is written for generic ‘phenytoin 50mg chewable tablets’ or the brand ‘Epanutin Infatabs 50mg chewable tablets’ and no licensed product is available, the prescriber may want to consider an alternative, PSNC has indicated.
If the prescriber wishes to prescribe an unlicensed preparation, the prescription should be amended to read: ‘Phenytoin 50mg chewable tablets (Special Order)’ or ‘Dilantin Infatabs 50mg chewable tablets (Imported (Canada))’.
Reimbursement will be for what is written on the prescription. If the prescription indicates that a special order/unlicensed product is to be supplied, then the reimbursement will be for the unlicensed product. If the prescription does not indicate a ‘special order’ is required, the reimbursement will be the list price for the licensed product.
When endorsing a prescription which requests the unlicensed product should be supplied, this should include:
• quantity dispensed;
• pack size;
• price per unit less any discount/rebate;
• manufacturer/importer MHRA licence number;
• batch number;
• specials procurement fee endorsement of ‘SP’.