During the changeover from brand to generic olanzapine, it is recommended that prescribers and community pharmacists discuss this change with their patients and their carers to reassure them that their treatment has not changed in any way and that the new products are as efficacious as the originating brand, Zyprexa.
Prescribers may experience a few patients who are resistant to the change and occasional short term prescribing of the brand Zyprexa may be necessary to keep patients engaged with treatment. This may also be a useful opportunity to carry out the usual physical health checks required for patients receiving antipsychotics such as such as weight, blood pressure, blood glucose, serum lipids and prolactin if not done within the past year in line with the summary of product characteristics for olanzapine.
A few patients will be receiving treatment with Zyprexa Velotabs, a rapidly dissolving oro-dispersible preparation. The generic olanzapine oro- dispersible preparations tend to dissolve slower than the Zyprexa Velotabs. Again patients should be reassured that their treatment is not inferior and that this will not interfere with treatment. The only difference will be the longer dissolution and longer absorption of olanzapine. However for a once daily preparation, this will not affect the ability of treatment to treat the patient’s mental health problem.
During the summer months, trifluoperazine tablets have been in extremely short supply and this has created difficulties for prescribers and pharmacists within our trust, as well as in primary care. Most patients have been successfully managed by switching to trifluoperazine syrup which is available as a special product from Rosemont Pharmaceuticals and other suppliers. While this is more expensive than tablet formulations, it will help to maintain the patient’s treatment.
The good news is that trifluoperazine tablets are expected to be available once again from early November 2011 and patients will be able to transfer back to tablets thereafter. Prescribers should liaise with their local community pharmacies to confirm availability of the tablets before issuing prescriptions for tablets next month.
Generic orphenadrine tablets have also been in short supply in recent weeks. Within BSMHFT, we have been able to obtain supplies of the brand Disipal. Although these are more expensive, they again help maintain normal supplies to patients.
We would be interested to hear of experiences from the switch from branded olanzapine to generic alternatives and are happy to answer any problems with regards to the supply of mental health medicines. You can contact the trust pharmacy service on 0121 301 5160 or 0121 301 5184.
Nigel Barnes, director of pharmacy and medicines management