[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-508531-105":59,"doc-detail-508531-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","shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-for-primary-care-and-community-pharmacy","Shortage of Pancreatic Enzyme Replacement Therapy (PERT) - Actions for Primary Care and Community Pharmacy","","Memo outlines a National Patient Safety Alert superseding a prior Medicines Supply Notification due to limited Pancreatic Enzyme Replacement Therapy (PERT) supplies. It specifies shortages for Creon 10,000/25,000 and Nutrizym 22, while Pancrex V remains available but cannot meet increased demand. Guidance covers adult PEI uses, patient identification, one-month prescribing limits, and staged management actions. It also details Phase 1–4 options, unlicensed import prescribing, and community pharmacy ordering, supply continuity, and EPS limitations.",{"@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/shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-for-primary-care-and-community-pharmacy/508531/",{"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/shortage-of-pancreatic-enzyme-replacement-therapy-pert-actions-for-primary-care-and-community-pharmacy/508531.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":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What changed in the medicines supply notification for PERT on 4 July 2024?","Question",{"text":112,"@type":113},"A National Patient Safety Alert from DHSC superseded Medicines Supply Notification MSN/2024/054, and it confirms limited PERT supplies.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which PERT products are in limited supply or unavailable, and until when?",{"text":117,"@type":113},"Creon 10,000 and Creon 25,000 are in limited supply until 2026, Nutrizym 22 is out of stock until mid-August 2024, and Pancrex V remains available but cannot support increased demand.",{"name":119,"@type":110,"acceptedAnswer":120},"What primary care steps are required when patients are identified as affected by the NatPSA?",{"text":121,"@type":113},"Clinicians should identify affected patients via Ardens CAS alert searches, amend quantities to a maximum one month’s supply, refer to the relevant position statement for clinical management and storage, and provide patient advice based on supply phase.","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},508531,1791308611,{"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":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"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":144,"preview_page_count":4},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","To: South East London primary care colleagues 4 July 2024  \nShortage of Pancreatic Enzyme Replacement Therapy (PERT)  \nThe Department of Health & Social Care (DHSC) released a National Patient Safety Alert - DHSC that superseded the Medicines Supply Notification (MSN/2024/054) which was issued on 09 May 2024. There are limited supplies of pancreatic enzyme replacement therapies (PERT) .  \n• Creon® 10,000 and Creon® 25,000 capsules are in limited supply until 2026.  \n• Nutrizym® 22 capsules are out of stock until mid-August 2024.  \n• Pancrex V® capsules and powder remain available but are unable to support an increase in demand.  \nPERT is indicated for the treatment of pancreatic exocrine insufficiency (PEI) such as in cystic fibrosis (CF), pancreatic cancer, and pancreatitis.  \nPlease check the Medicines Supply Tool for the latest information on supply issues, actions to take, alternatives to use, and expected resolution dates.  \nPlease note that the advice in this memo is designed for adults with PEI, clinicians are asked to seek specialist advice for children with PEI.  \nActions for primary care clinicians:  \n1. Identify patients affected by the NatPSA through the Ardens CAS alert searches (Appendix 1) .  \n2. Amend the quantity and prescribe a maximum of one month’s supply at a time.  \n3. Refer to the Position Statement Shortage of PERT HealthCare Professionals Version 3 for clinical management suggestions and storage advice during the recent extreme weather.  \n4. Depending on the supply available, please advise patients in accordance with the  \nPosition Statement Shortage of PERT Patient Advice Version 3  \nWhere suitable, this document can be shared with patients for information as it is also directed at patients~~:~~  \nPhase 1 – Intermittent supplies available  \n• Confirm dosage with patients and advise patients not to stockpile.  \n• Advise patients to request a repeat prescription as soon as their previous prescription has been dispensed to give the community pharmacist time to source the medication.  \n• Prescribe PERT on a separate prescription (FP10) or an electronic prescription which should not be sent to a nominated pharmacy unless the medicine is confirmed to be in stock at that pharmacy.  \n• Prioritise available Creon® 10,000 capsules for children and those who are unable to take Creon  \n25,000 capsules only.  \n• Prioritise remaining stock of Nutrizym® 22 capsules for patients unable to tolerate Creon® capsules.  \n• If patients normally take Nutrizym® 22, and are unable to tolerate Creon 25,000, please prescribe Pancrex V® 340mg.  \n• Refer to Appendix 2 for equivalent dosage information, if alternative PERT is prescribed due to the changing availability of products – please note people with CF should not be switched to different preparations unless advised by their CF specialist centre.  \nPhase 2 – Limited supplies  \nWhen supplies are limited, clinicians may want to consider the following options to make sure the supplies last longer(applicable to non-cystic fibrosis indications only) .  \n• Prescribe a proton pump inhibitor or H2 receptor antagonist to reduce acid degradation of the PERT and optimise efficacy;  \n• Based on the symptom severity, discuss dose reduction with patients as recommended on the position statement;  \n• Where symptoms remain despite a dose of ≥10,000 units lipase/kg/day or 100,000 units lipase with a meal, review whether other causes of the symptoms should be investigated before increasing the dose of PERT further;  \n• Prescribe medication to support symptom control such as diarrhoea.  \nPhase 3 – Insufficient supplies and patients have abdominal symptoms  \n• Provide advice to manage symptoms as recommended on the position statement.  \nPhase 4 – No supplies available  \n• Where licensed alternatives are unavailable, please work with local pharmacy teams to ensure orders can be placed within appropriate time frames. Prescribe MHRA approved unlicensed imports of PERT only (Appendix 3) .  \n• The e","cbCaip4PkqKKiawt","https://ap.wps.com/l/cbCaip4PkqKKiawt","pdf",600521,"English","# South East London primary care memo\n## Background and medicines supply changes\n## Intended patient group and indication\n## Actions for primary care clinicians\n## Phase 1 to 4 management options\n## Actions for community pharmacy\n## References and appendices","[{\"question\":\"What changed in the medicines supply notification for PERT on 4 July 2024?\",\"answer\":\"A National Patient Safety Alert from DHSC superseded Medicines Supply Notification MSN/2024/054, and it confirms limited PERT supplies.\"},{\"question\":\"Which PERT products are in limited supply or unavailable, and until when?\",\"answer\":\"Creon 10,000 and Creon 25,000 are in limited supply until 2026, Nutrizym 22 is out of stock until mid-August 2024, and Pancrex V remains available but cannot support increased demand.\"},{\"question\":\"What primary care steps are required when patients are identified as affected by the NatPSA?\",\"answer\":\"Clinicians should identify affected patients via Ardens CAS alert searches, amend quantities to a maximum one month’s supply, refer to the relevant position statement for clinical management and storage, and provide patient advice based on supply phase.\"}]","Shortage of Pancreatic Enzyme Replacement Therapy (PERT) - Actions for Primary Care and Community Pharmacy | PDF",1791226574,15]