Prograf

[Brummi]

Four days ago I handed a prescription in for some prograf, when I went to pick them up today I got told they had not got any. It seems there is a supply shortage from the manufactures . Has any one else had this problem. I am now down to two days supply left, ok I will sort something out on Monday but this is just a question to see if this is a a national problem...

[Hidden]

I often have to wait for my regular pharmacist to order them when I hand in my prescription but they invariably come next day. This has been the case for the last 4 years so no suggestion of a shortage. I would be interested to hear more.

[Hidden in reply to Hidden]

I was told that there is a problem with distributors who aren't keen to hold stocks but that the drug is freely available from the manufacturer.

[PeterP54 in reply to Hidden]

Just very occasionally have my regular pharmacist not had them but has been able to obtain them the next day.

Most often however, I find that they have been imported and repackaged (Still appear to be made in Ireland). My current box is from Poland (I think). Greece has been another country of origin. Drugs packaged for other markets usually come in boxes with different quantities E.g. Sometimes I get 50 tablets and sometimes 2 X 30 (=60).

I have an excellent GP and pharmacist which probably helps.

[carmik]

Not sure on this one we can't get it from our GP anymore as the PCT refused to fund it. Transplant Clinic supply ours 6 months at a time on a script for our local chemist.

If you ring the TP clinic they should issue it straight away.

[Brummi in reply to carmik]

Thank you. I will try the co-ordinators tommorow. I have not had a problem before.

[PeterP54 in reply to carmik]

Disgusting attitude from your PCT. Have you spoken with your MP? This would be front page news if t was a cancer drug.

[RodeoJoe in reply to PeterP54]

No I think that's the way it works. I have to get mine prescribed at Kings, I can then take that to my local pharmacy. But my local GP will not prescribe it.

King's budget for pharmaceuticals is huge compared to your local PCT.

[PeterP54 in reply to RodeoJoe]

Hi

See my reply to Bolly below. You seem to confirm my belief that GPs refusal is purely one of budgets.

The transplant centre sets my medication level and writes to my GP advising what it should be. The transplant centre monitors bloods and tacrolimus levels

[Brummi in reply to PeterP54]

My GP has NOT refused to perscribe them. The pharmacy I go to has had a problem getting them from the suppliers.

[Bolly in reply to PeterP54]

PeterP54 some drugs are best monitored by a specialist rather than a GP, usually in the patients interest. In these cases its the hospital and hospital consultant who prescribe and the hospital pharmacy in most cases who dispense. This is so the patient is properly monitored and cared for and ensures they attend clinics for their meds. In many cases of liver disease and transplant, the GP isnt the best person to be prescribing medication and/or monitoring due to the compexity. So not a disgusting attitude at all, more a sensible, safe attitude IMHO

[PeterP54 in reply to Bolly]

I would argue that my GP is unable to care adequately for my needs if they are not fully involved in my prescription. If they are not prescribing my Tacrolimus do they have to rely on the patient remembering what drugs they take and their dose? 5mg or 0.5mg? Easy to confuse for the non medic.

In my case, I know that the transplant team write regularly to my GP with updates on blood tests and any changes to prescription.

What if I go to my GP and they prescribe a drug for some other condition that potentially reacts with Tacrolimus? Taken to its logical conclusion the safest option for the patient is to not to consult their GP about any health condition and just go to the transplant centre. A recipe for potential disaster and extra costs I suggest.

I do actually remember a conversation with my transplant team about Tacrolimus prescription and whether my GP would prescribe or not. I am sure that their suggestion for GPs not wanting to prescribe was purely one of budgets and costs.

[Bolly in reply to PeterP54]

I can't comment on your case Peter, and I cant comment on transplant patients medications as I dont have personal experience of transplants, though I am on a medication commonly given to transplant patients (mine is for AIH) and my GP prescribes it. But I am on another medication which HAS to be prescribed and monitored by my liver specialist, nothing to do with budget etc as far as I'm aware more because my liver specialist is experienced with the drug. I dont expect my GP to be a specialist in anything (except perhaps a good bedside manner, lol!) as they are called 'general' practitioners. GPs only get a very small portion of their training given over to liver disease, let along rare or complex liver disease. You ask about drug interactions and that is a good point, but I was replying about drug monitoring.

[Bolly in reply to PeterP54]

"do they have to rely on the patient remembering what drugs they take and their dose?" - I would hope so! If the patient is not mentally competent enough to manage this, that would hopefully be picked up and an advocate appointed.

[PeterP54 in reply to Bolly]

I'm up to 7 different medications at the moment. Some doses are in milligrams and some micrograms. Frequencies vary between daily, twice daily and weekly. Some are known by their brand name (which changes depending on what the pharmacist has in stock) and some by their generic name.

I know which tablets to take and when but I carry my prescription counterfoil in my wallet (in case of accidents). Apart from the two main drugs (Tac and Pred), I couldn't reliably tell you the dose of the others.

I wouldn't want my doctor to rely on my memory to tell him what to give me as I agree with you on GP training and knowledge.

[Bolly in reply to PeterP54]

Absolutely agree with you Peter that neither you nor your medics should rely simply on patient memory for what drugs and what doses. Hopefully you have your tablets labelled at home with your name, name of drug, dose of drug and administering instruction and if you are at the GP they have it all on their computer and if you are the pharmacy they have it on their computer. I have a pill dispenser for my meds which I fill once a week so i dont miss a dose of any of them and of course that doesnt identify the drug, but i guess the chances of my being randomly asked what drug or what dose without being able to access my prescription details are fairly small. You can also get meds dispensed in a blister pack by a pharmacist so that you only take a drug at the correct time of day these blister packs have a sheet attached with details of the meds in the blisters, often including the colour, shape and identifying markings of each tablet.

[Brummi in reply to Bolly]

I would like to add that my consultants keep in contact with my GP and state what I need and the GP issues my perscriptions..

[bestiebabe in reply to Brummi]

Brummi...I am listening to you.... I have found a shortage of adaport (tacrolimus)...that seems to be rife as well. I get mine from GP as well...see I do read posts..lol

[carmik]

Glad to help good luck

[Hidden]

Yes xxx we had similar problem but the chemist managed to get hold of 1 box 'urgently' xx what dose ??? We have 3 x 5mg boxes - robs been out down to 4mg twice a day now xx

[Brummi in reply to Hidden]

I take 5mg a day. Hopefully all will be sorted on Monday...

[Hidden in reply to Brummi]

Any probs let me know and I can post a box to you xxx

[Dan68]

My chemist always has to order them. Only takes a day or two.

Birmingham ensure I have 1 month in advance at home so I don't have any problems. I'm on two x 2mg tablets a day now.

Danny

[Tracy0512]

Usually takes a day or so to get in to local pharmacy. But Gp won't be about to prescribe soon it will have to come from hospital or suppliers direct to pharmacy. It's all whole transplant drugs. My partner has a liver transplant and I also work at his doctors .