I have bronchiectasis with colonised pseudomonas aeruginosa which is treated with nebulised Colomycin twice a day. I have just been informed by my pharmacy that they have been unable to source my monthly supply of Colomycin 2million IU. It seems that there is a national shortage of the bulk supply, and Teva have been importing very small amounts from Spain. I will have to contact my consultant on Monday to see if there is an alternative I could use.
Trevor
That’s not great Trevor. I hope your consultant can help you. Take care xxxx
When I was nebulising it I quite regularly was unable toget it at the chemist. My consultant took oversending 3 months supply at a time fromthe hospital and no problems after. Try ringing your consultant’s sec and asking them to send it to you. Goid luck
It's good to know that that's a possibility. Many thanks for your advice.
Seconded: the hospital may well be your best bet, at least in the short term. However, I understood the Teva agreement was from earlier in the year and applied to 1mu vials, not the 2mu. The PSNC site is also not currently listing colomycin as being an issue at all. At the risk of being cynical, but from personal experience, drug shortages can occasionally be a handy reason for pharmacies not to work harder to source something that their usual supplier is short on, and there is a requirement for them to either source it elsewhere, or provide a suitable alternative if humanly possible. A possible option would include doing two vials of either the Teva or a different brand at the lower dose (both profile and Kent pharma do a 1mu vial). They may need a new script to facilitate this, but there are ways around it.
That is so true and has been my experience in the past
Eek, that’s a worry. I rely on colomycin too, although I have the Promixin brand. I haven’t heard of any shortages
If it’s any reassurance, I’m not aware of any issues with promixin, either - Bod is on it. As per my other reply, Teva are the only supplier that make a 2mu vial, but there are other 1mu vials available. As far as I’m aware, promixin is no different to any other brand of colomycin, beyond the ongoing commercial arrangement with Philips for it and iNeb use on the NHS.
Hanne how did you get the promixin brand I was told it is REALLY expensive
Hello Sohara, how’re you doing? I don’t think it’s that much more than generic colomycin. I’ve got “£80 per month” in my head, not sure if that’s right.
About 8 yrs ago my local consultant (Sussex County) offered to arrange for me to have an I-neb, because it’s SO much faster than a compressor-type. He told me Philips Respironics would loan me one if my gp agreed to prescribe the Promixin brand. So he wrote to my gp & said he’d like me to have Promixin, the gp agreed, and bingo I got an I-neb.
You’re at the Brompton aren’t you? I’m sure they’d arrange this for you.
I am I did the trial there today, they said the Promixin was too expensive now so I doubt they will I will ask the consultant when we speak. Not been on here all year, not been doing too well , trouble is now I have to have IV antibiotics as the pills no longer work that is why I was hoping I could have the Colomycin. Thanks for your reply REALLY appreciate it I hope you are doing well too Love Sheila
It’s a lot more than that, Hanne - Teva is the cheapest brand available to the NHS, and comes in at £108 per month for 1mu twice a day. By comparison, Promixin is £404 per month, which is why you get £3k worth of nebuliser and the consumables free of charge as long as the NHS will continue to pay for the promixin. In practice, Philips make profit within the first 6 months. My understanding is that’s the reason why iNebs are not commonplace on the NHS outside of cf.
Where did you see those figures, Charlie? Because the ones I saw when I googled put Promixin at £138 for 30 days. I think it was from NICE but will have to check. It’s very unfair when non-cf is treated so much more meanly than cf. If you’re nebulising colomycin, salbutamol, ipratropium and hypertonic saline 12 times a day, what difference does it make whether your bronchiectasis is cf or non-cf? Grr.
Having said that, when I’ve been on Foulis or Victoria with other non-cf patients, all of whom have P.A., they’ve all had I-nebs too.
It’s the current NHS tariff price as per the BNF. All drug entries have a link at the end to ‘medicinal forms’ which documents the current cost of every brand and dose approved for use on the NHS. The NICE price you mention is from the guidelines from 2014: for 30 vials now it’s £202, which you would then double for the monthly cost.
bnf.nice.org.uk/medicinal-f...
The likely reason for many people on Foulis having an iNeb is purely that it’s the RBH. From what I’ve seen and discussions I’ve had with various staff that straddle both adult services and paeds, there is better parity of care at the Brompton for cf and ncfb. Not perfect by a long shot, but better.
Thanks Charlie that is brilliant info to have , but if I failed the trial for Colomycin, they may not let me have any of the other ones you mentioned . I have a telephone app in August I will try to discuss it then. Thank you SO much Charlie & Hanne xxx
Hi when there was a shortage of my drug during lockdown the pharmacist at boots chemist gave me a recommendation for an alternative treatment and the doctor approved it within minutes and it was prescribed same day.
Many thanks for your responses. I managed to contact my consultant this morning and she has arranged for a 3 month supply to be collected from the hospital tomorrow afternoon.
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