[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-508233-105":59,"doc-detail-508233-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","natpsa2024007dhsc-shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-required","NatPSA/2024/007/DHSC - Shortage of Pancreatic enzyme replacement therapy (PERT) - Actions required","","National Patient Safety Alert on the shortage of pancreatic enzyme replacement therapy (PERT), issued 24-May-24 under reference NatPSA/2024/007/DHSC. The alert supersedes Medicine Supply Notification MSN/2024/054 and explains limited availability of key products, including Creon® 10,000 and 25,000 capsules, Nutrizym® 22 capsules, and reduced support for increased demand. It outlines safety-critical actions for clinicians and pharmacists, including prescribing maximum one month’s supply, prioritising specific strengths, considering optimisation strategies for indications beyond cystic fibrosis, and using unlicensed imports only when licensed options are unavailable.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/natpsa2024007dhsc-shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-required/508233/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/natpsa2024007dhsc-shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-required/508233.png","ImageObject",300,407,{"name":92,"@type":93},"kopisore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-09","2026-10-05",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What products are affected by the PERT shortage in this alert?","Question",{"text":112,"@type":113},"The alert states limited supply of Creon® 10,000 and 25,000 capsules until 2026, Nutrizym® 22 capsules out of stock until mid-August 2024, and that Pancrex V® remains available but cannot meet increased demand.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What is the key prescribing action for clinicians and prescribers?",{"text":117,"@type":113},"Clinicians are instructed to prescribe a maximum of one month’s supply of PERT for all patients at a time.",{"name":119,"@type":110,"acceptedAnswer":120},"When should unlicensed PERT imports be used?",{"text":121,"@type":113},"Unlicensed imports should be considered only where licensed alternatives are unavailable, with local pharmacy teams placing orders within appropriate timeframes, and patients should be referred to a specialist if options are not suitable.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},508233,1791512172,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Shortage of Pancreatic enzyme replacement therapy (PERT)  \n\n| Date of issue: | 24-May-24 | Reference no: | NatPSA/2024/007/DHSC |\n| --- | --- | --- | --- |\n| This alert is for action by: All organisations involved in prescribing and dispensing pancreatic enzyme replacement therapy (PERT) . |  |  |  |\n| This is a safety critical and complex National Patient Safety Alert. Implementation should be co-ordinated by an executive lead (or equivalent role in organisations without executive boards) and supported by clinical leaders in community pharmacy, GP practices and clinical leaders in pharmacy, dietetics, respiratory , hepatobiliary and cancer services. |  |  |  |\n\n\n| Explanation of identified safety issue: |\n| --- |\n| This alert supersedes the Medicine Supply Notification (MSN/2024/054) issued on the 9th May 2024.\u003Cbr>There are limited supplies of pancreatic enzyme replacement therapies (PERT) .\u003Cbr>• Creon® 10,000 and 25,000 capsules are in limited supply until 2026.\u003Cbr>• Nutrizym® 22 capsules are out of stock until midAugust 2024.\u003Cbr>• Pancrex V® capsules and powder remain available but are unable to support an increase in demand.\u003Cbr>The supply disruption of Creon® capsules is due to limited availability of active pharmaceutical ingredients and manufacturing constraints to produce the volumes required to meet demand.\u003Cbr>The supply disruption for Nutrizym® 22 capsules has been caused by a manufacturing issue and increased demand because of the Creon® supply issue.\u003Cbr>PERT is indicated for the treatment of pancreatic exocrine insufficiency such as in cystic fibrosis, pancreatic cancer, and pancreatitis. There is no clinical alternative to PERT.\u003Cbr>Unlicensed imports of Creon® capsules and alternative brands of PERT may be sourced, lead times vary.\u003Cbr>Information relating to imports is available below and on the SPS Medicines Supply Tool which also details any changes to resupply dates, updates to this communication and an up-to-date supply overview. |\n\n\n| \u003Cbr>Actions required |\n| --- |\n| Actions for clinicians and prescribers of PERT tobe completed 10/06/2024\u003Cbr>To remain in place only until the supply issues have resolved (see SPS Medicine Supply Tool):\u003Cbr>1. Clinicians should:\u003Cbr>a. prescribe a maximum of one month’s supply of PERT for all patients at a time.\u003Cbr>b. prioritise available Creon 10,000 capsules for patients unable to take Creon 25,000 capsules only. Note A\u003Cbr>c. prioritise remaining stock of Nutrizym® 22 capsules for patients unable to tolerate Creon capsules.\u003Cbr>d. where PERT is prescribed for indications other than cystic fibrosis, clinicians and prescribers should consider:\u003Cbr>• prescribing a proton pump inhibitor or H2 receptor antagonist to optimise efficacy Note B\u003Cbr>• if a dose reduction may be suitable for patients based on severity of symptoms Note B\u003Cbr>• where symptoms remain despite a dose of ≥10,000 units lipase/kg/day or 100,000 units lipase with a meal, whether other causes of the symptoms should be investigated Note B\u003Cbr>• prescribing medication to manage symptom control Note B\u003Cbr>e. prescribe unlicensed imports of PERT only where licensed alternatives are unavailable, working with local pharmacy teams to ensure orders are placed within appropriate time frames.\u003Cbr>f. immediately refer patients to a specialist for advice on alternative treatments if above options are not suitable.\u003Cbr>2. Pharmacists presented with repeat prescription for PERT should only supply the equivalent to one month’s supply in accordance with SSP060 and SSP061 . |\n\n\n| Additional information: |\n| --- |\n| Clinical Information\u003Cbr>Creon® gastro-resistant capsules and Nutrizym® 22 capsules are licensed for the treatment of pancreatic exocrine insufficiency. Each preparation contains different amounts of pancreatic enzymes. Many patients adjust their dose according to symptom management, but all patients should be counselled to re-titrate the dose if problems with digestion or weight loss occur.\u003Cbr>Note A: Supply of Creon 10,000 capsul","cbCaimjROrIht0up","https://ap.wps.com/l/cbCaimjROrIht0up","pdf",160896,"English","# Explanation of identified safety issue\n## Supply disruption summary\n# Actions required\n## Actions for clinicians and prescribers\n## Actions for pharmacists\n# Additional information\n## Clinical information and notes","[{\"question\":\"What products are affected by the PERT shortage in this alert?\",\"answer\":\"The alert states limited supply of Creon® 10,000 and 25,000 capsules until 2026, Nutrizym® 22 capsules out of stock until mid-August 2024, and that Pancrex V® remains available but cannot meet increased demand.\"},{\"question\":\"What is the key prescribing action for clinicians and prescribers?\",\"answer\":\"Clinicians are instructed to prescribe a maximum of one month’s supply of PERT for all patients at a time.\"},{\"question\":\"When should unlicensed PERT imports be used?\",\"answer\":\"Unlicensed imports should be considered only where licensed alternatives are unavailable, with local pharmacy teams placing orders within appropriate timeframes, and patients should be referred to a specialist if options are not suitable.\"}]","NatPSA/2024/007/DHSC - Shortage of Pancreatic enzyme replacement therapy (PERT) - Actions required | PDF",1791213593]