Please do not double up on lower dose preparation where a higher dose of the GLP1-RA is not available. There have been reports of this happening and this will exacerbate the shortages. Patients should only be prescribed one dose from one pen – do not give multiple pen devices or multiple doses to make up a dose.
If the patient is prescribed a lower dose than previously please ensure the patient is contacted for a clinical review to see if they require other medication for diabetes to be adjusted and to check for symptoms of hyperglycaemia.
Please see the guidance on managing the GLP-1RA shortage below:
Please also see the NPSA shortage of GLP1-RA update from 03/01/24 attached. The holding plan in Lothian is NOT to switch patients on Victoza/liraglutide currently as community pharmacies have been obtaining stock of liraglutide when required. We are working on a plan to manage this and will update the team as soon as we can or if shortages arise. Please get in touch if you have any issues obtaining liraglutide.
We now have data on patients who have been prescribed exenatide across Lothian and will contact all Practice Pharmacy Teams who are affected (there are a maximum of 2 patients per practice) with further information.
Currently only patients needing to be started on a GLP1-RA or those prescribed exenatide and require an alternative GLP1-RA as per the NHS Lothian Diabetes Guidelines should be prescribed oral semaglutide if appropriate – please see SmPC for further information – semaglutide is not recommended in patients with significant diabetic retinopathy.
Rybelsus 3 mg – Summary of Product Characteristics (SmPC) – (emc) (medicines.org.uk)
If you still have concerns regarding a particular patient please contact the appropriate clinical team:
WGH – WGH.DiabeticAdvice@nhslothian.scot.nhs.uk
