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Phenelzine (Nardil) - Not Available nationally - Aug to End October 2019

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  • Phenelzine (Nardil) - Not Available nationally - Aug to End October 2019

    Last edited by rafhelp; 29, September 2019, 12:43 AM.

  • #2
    They will probably blame Brexit again. However, this illustrates how the decline of the chemical industry in UK and dependence on imports is affecting everyday life.
    I used to sell MAOis in the 60s and I believe they are interchangeable in most pts.
    I will have a look on the net to see if any of the old ones still available for you. They fell out of use after some problems with cheese and other tyramine containing foods. Ther were replaced by the cyclines and then the SSRs.


    • BestFootFirst
      BestFootFirst commented
      Editing a comment
      Thanks for your response, jonep. I'd like to understand a bit more about 'unlicensed' in other countries, or whatever the phrase that was used.

      Fingers crossed, this medication can be sourced from elsewhere very soon ...

      [Edit - couldn't see where to find 'Reply' - but have now seen it ]

  • #3
    There is a company that specialises in obtaining unlicensed meds and those from overseas.. Name is Durbin.


    • #4
      John, many thanks for this information.
      I'll pass on the name of the company in the hope this company is able to supply the medication.
      This information may also be very useful if there are supply issues regarding other meds because of Brxit.
      I'm very grateful you've spent your time to find this name


      • #5
        They might be quite hesitant about procuring a special when there is technically a licensed product in the UK market (even if currently unavailable). Unfortunately one of the immediate reasons for this will be the cost as the product has a fixed price in the tariff of £22.50. If your GP specifically requests the medicine as a special and it clearly states as such they may be able to do something for you. Ultimately a private prescription for the special could resolve this but the price may be eye watering.

        Coming off MAOI's abruptly is not a great idea so you definitely need a solution.
        I remember when a blog was an individual boot.


        • #6
          MAOIs are a fascinating (to me anyway) example of the much derided "molecular roulette". Consider the sequence:
          Nicotinamide (Vitamin), Nicotinic acid (Vitamin and vasodilator), Isoniazide (tuberculostatic), iproniazide (Marsilid - tuberculostatic and anti depressant), Isocarboxazide (Marplan- antidepressant).
          Procarbazine (Natulan- cytotoxic).
          It was noticed that pts on isoniazide became cheerful and happy which led to looking at derivatives.
          Monoamine Oxidase Inhibitors work (or so i was taught) by inhibiting the breakdown of 5HT (Serotonin)..
          5HT is 5 hydroxy tryptamine , which is why tryptophan containing foods can cause trouble.
          I was taught brain chemistry in 70s so probably well out of date now.
          I remember a controversy when a company mixed tryptophan with Cadburys Drinking Chocolate and promoted as an antidepressant. DOH wanted to regard it as a food and therefore not available on NHS.
          You should find Durbin on the net.


          • #7
            It might be a long shot - have a google around availability in Eire.
            Pre-brexit EU rules about prescriptions apply and free-movement of goods etc.
            Plus - you can contact the pharmacy yourself and ask them what they need.
            47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
            2018 AD : Modern Man : I shopped, I clicked, I collected.
            How times change.

            If you find you have read something that has upset or offended you an anyway please unread it at once.


            • #8
              Many thanks guys, for your responses

              Having contacted the Practice Manager last Monday, ie 2 days ago, to ask what they were / had been doing regarding this situation, she contacted me today to assure me they have sourced 2 months supply for me. Obviously, this is a great relief to me.

              As you say, stopping MAOIs suddenly is not a good idea so, fortunately, it appears I’ve been spared this, at least for the time being.

              I admit I don’t understand the procedures nor implication of sourcing medications from outside of UK market but, as I don’t work in a pharmacy, I don’t need to know. However, if that’s the only way certain prescribed medications can be sourced, then surely that has to be. I can understand if the cost is increased given increased demand in such circumstances.

              I’ve found the history of Phenelzine rather interesting so, when I have a bit of time, I’ll be interested to find out more about this. Thanks for this information.

              Does this mean I’m unlikey to develop TB … ??? Ha Ha

              Oops!!! I would have thought mixing medication with Cadbury’s Drinking Chocolate would be rather ‘invasive’ as not having recipients permission, nor knowledge.

              Thanks for the tip re Durbin. I’ll pass that information and url onto the pharmacy.

              I did have a try to find info re availability in Eire but didn’t come up with anything. Again, tho, I’ll pass on the suggestion to the pharmacy as they will likely have better access to information re Eire.

              So, I’m still rather puzzled, and disappointed, that given this shortage was identified and available in July 2019, why haven’t the pharmacies and surgeries been aware of this and taken measures much sooner. It seems that another local person, and myself, have been how the pharmacy and my surgery have become aware and only since last Friday, ie 5 days ago.

              I have seen documents, on internet, from other CCGs outlining what the pharmacists and HCPs should be doing to manage this situation, including checking with patients how long will their current supply last, suggestions to refer patients urgently to Mental Health Team for advice etc but none of this seems to have been the case in my local CCG.

              Is there not some ‘system’ whereby the surgeries and pharmacists are given this sort of information so that they can manage this more effectively?

              Anyway, many thanks for all your help, advice and support. For now, it seems Phenelzine has now been sourced so I hope other patients on Phenelzine have their supply arranged.

              With regard Brexit, it seems other medication shortages may become a reality, in which case I just hope there is a better ‘system’ in place for necessary meds to be sourced.



              • #9
                Originally posted by BestFootFirst View Post
                Many thanks guys, for your responses

                Is there not some ‘system’ whereby the surgeries and pharmacists are given this sort of information so that they can manage this more effectively?

                Unfortunately not. With the sheer number of out of stocks and the variability between the myriad of UK wholesalers there is no definitive way to really manage this without a huge resource investment. With pharmacy funding being cut it's likely this may only get worse.

                GP's usually have no visibility of stock availability.
                I remember when a blog was an individual boot.


                • #10
                  When working at Central MK for the shoe. We had a few pts who presented a script and when we said we did not have stock, they would get irate and say " the Dr said you would have this in stock". Usually meant we would have to deliver to them (sometimes a fair distance) the next day. Often it was a DD who did not have the item and told the pt we were certain to have it.


                  • #11
                    Looks like you've got sufficient supply for now but,

                    Several importers are sourcing phenelzine (Nardil) from abroad at the moment. We've used Clinigen. (Clinigen recently bought out IDIS, a major supplier of specialist imports to the UK market). Clinigen have obtained both US packs of Pfizer brand Nardil (tubs of 60), and various generics from elsewhere. They cost a shed load of money regardless!




                    • #12

                      I am in the same situation as BestFootFirst although I only have tomorrow’s dose before I have run out. I have found my surgery to be extremely unhelpful and hadn’t even notified me, when I put my repeat prescription in, that there was a problem. I have now literally been advised to ring around pharmacies myself to see if any have stock.
                      I have also been searching the internet for further advise/sourcing and hence this is how I have ended up on here begging if anyone can help me out before I go ‘cold turkey’ after tomorrow.
                      My doctor, when I contacted her has offered me Pregabalin but I have no idea if this will work for me as the only one that ever has, has been Nardil...



                      • #13
                        Oh dear, a sorry situation. Contact Durbin and Idis to see if can accept EPS (Electronic Prescription Service). To ensure a dose by tomorrow will have to be couriered or picked up by you. Likely to be expensive. Precursor for 5HT present in some foodstuffs (ie those you were told to avoid) Chocolate, broad beans, blue cheese. Possible John Bell and Croyden near Harley street may have supplies of phenelzine or possibly Marplan (different MAOI).
                        Try your local mental hospital pharmacy first.


                        • #14
                          Thank you so much Johnep for your prompt reply...I have found out you can ask your own pharmacy to go down the unlicensed route and in turn they can request that the NHS pay...but am now being told prescription due in in a weeks time...normal route? I’m not convinced so will carry on sourcing other options and follow up your advise...
                          Now for a bit of chocolate and cheese gluttony to tide me over!


                          • #15
                            Well, at least you can joke, so shows your depression not as bad as you thought.
                            Trust all goes well.