Drug shortage means prescribers asked to switch treatment for acute respiratory problems in COVID-19 patients

A shortage of the drug methylprednisolone to support “business as usual” has led to organisations being asked to stop prescribing it for the treatment of acute respiratory distress syndrome (ARDS) in patients with COVID-19. 

A supply disruption alert from the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement, released on 14 January 2021, said that although some wholesalers were showing stocks of methylprednisolone, there was “insufficient stock” in the UK to support business as usual use, such as in oncology and multiple sclerosis, as well as the emerging treatment of ARDS in COVID-19.

It said that organisations using methylprednisolone in the management of ARDS in COVID-19 patients should review prescribing practice and switch to an alternative agent, and ensure that COVID-19 patients receiving oxygen support are prescribed dexamethasone 6mg daily.

In addition, local pharmacy teams should only order methylprednisolone for business as usual indications in line with that demand, and no more than four days stock, the alert said.

Methylprednisolone is used to treat a wide range of indications where a rapid and intense corticosteroid effect is required.

The DHSC said it was working with the manufacturer, Pfizer, to review future supplies of the drug to the UK, but anticipated that it would be “unable to support additional COVID-19 demand for the foreseeable future”.

A spokesperson for Pfizer said that there had been an “extraordinary recent increase in demand” of methylprednisolone owing to an “unexpected change” in some local COVID-19 protocols, but that this had been “resolved”.

“We are working closely with the Department of Health and Social Care, and other key partners, to ensure steady supplies,” the spokesperson said.

“These supply fluctuations have now settled and there is sufficient supply of methylprednisolone available in the UK to meet usual market demand.”