Two serious shortage protocols (SSPs) for cefalexin oral suspension sugar free have been issued, allowing pharmacists to substitute a non sugar free version instead.

The antibiotic is used to treat infections including urinary tract infections (UTIs), pneumonia and other chest infections.

From today, community pharmacists must supply Cefalexin 125mg/5ml oral suspension (non sugar free) in place of Cefalexin 125mg/5ml oral suspension sugar free, for every 5ml of the latter that is prescribed.

And where Cefalexin 250mg/5ml oral suspension sugar free is originally prescribed, pharmacists must supply the same amount of Cefalexin 250mg/5ml oral suspension (non sugar free).

Pharmacists have been told to exercise their professional judgement to ensure the alternative product is suitable for the patient.

And they should ensure that the patient or carer is informed that the new supply contains a small amount of sugar.

If the substitution is not considered suitable for the patient, they should be 'promptly' referred to their prescriber for further advice.

And the pharmacist should inform the prescriber if the substitution is made.

Currently, these SSPs are set to expire on Friday 31 January 2025, but may be amended or revoked at any time.

Alongside the SSPs, Community Pharmacy England (CPE) also highlighted that 'a large number of SSP claims' were being 'deemed invalid by the NHSBSA [NHS Business Services Authority] due to incorrect endorsements applied by PMR [Patient Medication Record] systems and/or pharmacy staff'.

The negotiator said that pharmacy owners should 'regularly reconcile the value of SSP fees on their payment schedules against the number of SSPs declared on the FP34C submission form', and pointed to its guidance on reconciliation of SSP claims.

Defective WockAir inhalers recalled

Pharmacists must also be aware of a recall notice issued by the Medicines and Healthcare products Regulatory Agency (MHRA) yesterday on behalf of inhaler manufacturer Wockhardt UK Limited.

Pharmacies must stop supplying batch NV6057 of an inhaler two-pack immediately, and all remaining stock must be quarantined and returned to the supplier.

The MHRA said that the batch was being recalled 'as a precautionary measure following the identification of a low number of units which may have a defect in the "top case" resulting in a dose not being able to be dispensed'.

The manufacturer said the issue was a 'rare defect' and does not affect all inhalers within this batch.

'If a patient were to receive an inhaler with a defect, the defect would be obvious from the first attempted use of the product as the inhaler would not provide a dose.

Patients using an inhaler from this batch should continue to use the inhaler as the defect would not impact a working device.

'Patients that have an unopened inhaler from the batch in the table are advised to test the inhaler is working before their current inhaler runs out,' the alert said.

And any suspected adverse reactions should be reported via the MHRA Yellow Card scheme, the MHRA said.

In October, pharmacies were told to contact all patients dispensed a specific batch of the beta blocker labetalol that may contain the wrong medication.

And last month, a spray sold to delay ejaculation was recalled after its manufacturer revealed it was not authorised by the MHRA.