The Department of Health and Social Care (DHSC) has issued a medicine supply notification for immunosuppressive drug Capimune (ciclosporin) 25mg, 50mg and 100mg capsules.
Capimune is used to prevent rejection of new organs following a transplant operation as well as in the treatment of rheumatoid arthritis, severe dermatitis and psoriasis or nephrotic syndrome.
While another brand of ciclosporin (Deximune) is available and can support a full uplift in demand, DHSC said that switching between formulations without close monitoring may lead to clinically important changes in ciclosporin level.
It said that switching between a branded and a generic formulation, or between generic formulations, should be carried out in consultation with the specialist team.
Patients must be monitored closely for changes in ciclosporin level where clinically appropriate, according to the specialist’s decision, as well as changes in serum creatinine, blood pressure, disease control or transplant function, and adverse effects, it added.
The Psoriasis Association said that ciclosporin remains a popular treatment option for people with moderate to severe psoriasis, so any shortage would be felt by patients – particularly women of childbearing age, as it can be used during pregnancy, while some immunosuppressants cannot.
It would also particularly effect patients in areas where the treatment pathway heavily relies on patients having tried Methotrexate or Ciclosporin before consideration of a biologic.
PSNC said that capimune is not a commonly dispensed item by community pharmacies – across England, it was dispensed less than 2,000 times in the past 12 months.
It added that any additional workload for community pharmacy teams is likely to centre around explaining the situation to patients and referring them back to the prescriber for a replacement prescription.
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