The number of out of stock, or unavailable, products is indeed very annoying for pharmacists and pharmacy staff - leading to a lot of frustration chasing down stock; and sometimes pharmacists will need to refer a patient back to the GP...
 
The LPC has had a number of requests from GP surgeries in both Gateshead and South Tyneside for support regarding this - as often the patient just turns up with the old prescription telling the receptionist that "the chemist says this isn't available and I have to have something else".
 
On these occasions the GP might have to be disturbed during a consultation - and one GP reported being interrupted several times with one patient...The GPs are often unaware of the shortages (and what is actually available) and would really appreciate a steer on what is prescribable - or indeed what would be an appropriate alternative.
 
I'm sure most of us do this most of the time, but it would really be helpful (and good PR for pharmacy) if the surgery was contacted on every occasion and help given - or a solution offered; so the new prescription is available for the patient, or the pharmacy, to collect and the GP doesn't need to be disturbed as much!
 
The practice pharmacists are helping out as much as they can - but this is a call for action for community pharmacists as we are ideally placed to help here and we really should step up to the plate...

I had a request the other day from a patient wanting Miconazole cream to treat athletes foot...but she is a breastfeeding mother.
 
When I examined the literature, the advice is to consult the GP; but for detailed information, and because the patient was in a hurry, I contacted the Regional Drug Information Unit in Newcastle to see exactly what the issue/problem is.
 
As usual and within a few minutes, I received an excellent response!
 
Basically, I was told that Miconazole is very poorly absorbed and so a small amount between the toes of a breastfeeding mother will lead to negligible absorption; and therefore there is only a very small risk indeed to the baby.
 
Armed with this information, the lady bought the product - and agreed to speak to the GP before using.
 
The Newcastle based Information Service is a really useful resource to use!

I had an interesting conversation with a company representative recently.
 
It turns out that the product "Dovobet ointment" will be available only in the 120g pack size in the near future as the 60g pack size will be discontinued.
 
The "gel form" will be available in both sizes.
 
The problem here is that if pharmacies receive prescriptions for 60g of the ointment, once it's gone, they will be able to properly supply the 120g and be paid for it...but the clinical indication for this product is clear - it shouldn't be used in a casual manner. Indeed the BNF states "apply once a day to a maximum of 30% of the body surface for 4 weeks (max of 15g daily); If necessary treatment may be continued beyond the 4 weeks or repeated on the advice of a specialist.
 
Now, we don't know what areas of skin are being treated -and treatment may rotate around the body as different body parts need to be treated - but by giving a larger pack, the temptation to overuse might be great...
 
Perhaps, we should provide patients with a MUR when supplying Dovobet to ensure appropriate use; and more importantly prevent inappropriate excessive application?