In response to the recent reports of HRT shortages, the British Menopause Society has produced this update on the current availability of HRT products. This provides guidance to BMS members, clinicians and patients who may be experiencing difficulties in obtaining HRT supplies.

There have been availability issues with many HRT products. Some of these are related to manufacturing shortages, while others are related to supply issues. The BMS has been reassured that these are temporary shortages which pharmaceutical companies and their suppliers are trying to resolve.

In the meantime, prescribers can consider equivalent preparations that provide a similar dose to what their patient is using. If an exact match is not possible, prescribers can seek guidance available on the practical prescribing chart on the BMS website and Menopause Matters website, to clarify equivalent doses.

Consideration could also be given to prescribing estrogen and progestogen separately to make the closest match or find a suitable alternative.

Different brands for the same medication may vary in appearance or excipients. However, they would provide equivalent amounts of hormones when used in similar doses.

BMS members can post prescribing queries on the BMS forum if any clarifications are required.

The information on stock availability and supplies below was obtained from the pharmaceutical companies producing these products.

Besins Healthcare (UK) HRT products

No shortage of supplies of their HRT products:

Oestrogel systemic oestrogen gel.
Utrogestan (micronised progesterone) 100 mg in continuous combined regimen and 200 mg in sequential regimens.

Evorel patches (Janssen)

Janssen have provided the following update on their Evorel patch products:

They indicated that availability of the Evorel range of products in the UK has been impacted following an unusual increase in demand over recent months, hence some pharmacies have been experiencing shortages of certain products. Their forecasted stock out dates may continue to fluctuate in the coming months with ongoing changes in demand, but the company is working to resolve this issue.

In the meantime, however, and while supplies are available, any pharmacies that are having difficulties to obtain the product from the wholesalers to whom Janssen supply, can contact Janssen directly by email on ‘JanssenUKCustomerServices@its.jnj.com’ or by telephone: 01494 567 400 and they would explain the process of placing an order with them directly to fulfil pending prescriptions and once an order is placed delivery of goods to the pharmacy is likely to be within two working days.

Estradot patches (Novartis pharmaceuticals):

Available. No supply shortages at present.

If difficulty obtaining supplies, company suggested contacting customer care on 08457 419 442; E-mail novartis.customercare@novartis.com. Frimley Business Park, Frimley, Camberley, Surrey, GU16 7SR.

Company happy to guide pharmacies on how to register and order directly if required with a view to a next working day delivery.

Estraderm MX patches

Estraderm MX 50 patches pack of 24. Available.
Estraderm MX 75 patches pack of 8. Available.
Estraderm MX 100 patches. Available.
Estraderm MX 50 patches pack of 8 available – Shortage of supplies.

Mylan HRT products

Elleste Solo: 1mg oestradiol. Available.
Elleste Solo: 2mg oestradiol. Shortage of supplies.
Elleste Duet 1mg oestradiol + 1mg norethisterone acetate. Shortage of supplies.
Elleste Duet 2mg oestradiol + 1mg norethisterone acetate. Available.
Elleste Duet Conti 2mg oestradiol + 1mg norethisterone. Shortage of supplies.
Femoston 1mg oestradiol + 10mg dydrogesterone. Shortage of supplies.
Femoston 2mg oestradiol + 10mg dydrogesterone. Available.
Femoston conti 1mg oestradiol + 5mg dydrogesterone. Available.
Femoston conti low dose 0.5mg 0estradiol + 2.5mg dydrogesterone. Available.
Zumenon 1mg oestradiol and 2mg oestradiol. Shortage of supplies.
Elleste Solo MX patches 40mcg transdermal oestradiol. Current shortage of supplies, but likely to be available later this month.
Elleste Solo MX patches 80mcg transdermal oestradiol. Current shortage of supplies, but likely to be available later this month.

Mylan website has an overview and stock availability page that could be accessed on: https://mywayhub.co.uk/en-gb/range

Novo Nordisk HRT products

No shortage of supplies of any of their HRT products:

Kliovance 1mg oestradiol + 0.5mg norethisterone acetate.
Kliofem 2mg oestradiol + 1mg norethisterone acetate.
Novofem 1 mg oestradiol + 1 mg norethisterone acetate.
Trisequens 2mg/2mg/1mg oestradiol + 1mg norethisterone acetate.
Vagifem 10mcg topical vaginal oestrogen.

For any further clarification or queries please contact the British Menopause Society by telephone, 01628 890 199, email admin@bms-whc.org.uk or additionally, for BMS members, through the BMS members’ forum.

Haitham Hamoda
Chairman, British Menopause Society