Amiloride oral liquid: Supply issue

Affected product

Biomed has advised Pharmac of an out of stock of amiloride hydrochloride oral liquid (1 mg per ml) due to issues sourcing the active ingredient. There may be limited stock of this product available.

Biomed is working to find a new source for the active ingredient.

Amiloride hydrochloride

• Presentation: Oral liq 1 mg per ml
• Brand: Biomed
• Pharmacode: 344710
• Subsidy: $33.71
• Measure / Qty: per 25 ml OP

Schedule listing for amiloride hydrochloride(external link)

Information for prescribers

We ask that you do not start new patients on amiloride oral liquid. You may like to consider amiloride tablets (funded from 1 December) or an alternative potassium-sparing diuretic(external link) for your patients who are taking amiloride oral liquid.

Information for community pharmacists

If there is a patient in the community who requires the oral liquid, please contact your local hospital pharmacy to discuss provision of supply through the hospital.

We have listed amiloride tablets in the Community Schedule from 1 December for those who can take tablets.

For hospital pharmacists:

The Schedule Rules say that Health NZ Hospitals may give any hospital pharmaceutical to a patient for use in the community, provided that:

• the quantity dispensed at any one time does not exceed the amount sufficient for up to 30 days’ treatment, unless:
  • it would be inappropriate to provide less than the amount in an original pack, or
  • the relevant Health NZ Hospital has a policy covering dispensing for discharge and the quantity dispensed is in accordance with that policy, and
• the Hospital Pharmaceutical is supplied consistent with any applicable restrictions in Section H of the Schedule (includes Indication Restrictions, Local Restrictions and Prescriber Restrictions).

We appreciate your continued support in ensuring a patient level impact is avoided.

Alternative tablets listed 

From 1 December 2024, we are listing two brands of amiloride 5 mg tablets for people who can swallow a tablet:

Wastage is claimable. Neither product is Medsafe registered. As such they will have to be prescribed and dispensed in line with the Medicines Act.

Prescribing and supplying an unapproved medicine

Section 29 of the Medicines Act 1981 allows for medicines that are not Medsafe approved to be prescribed and supplied to people. The medicine must be prescribed by someone registered with the Medical Council of New Zealand – such as, a doctor. 

We know supplying a medicine under section 29 is not ideal. In this case, however, this will allow patients to be able to access an appropriate treatment. 

We apologise for any inconvenience this causes. 

Advice for prescribing under section 29 – BPAC website(external link) 

Prescriber and pharmacist requirements for section 29 medicines – Medsafe website (external link)

Medsafe’s section 29 Declaration / Notification Form [DOC](external link)

What patients need to know about unapproved medicines – Healthify website(external link)

Expected resupply mid December 2024

Biomed advises that it expects supply to return to normal by mid-December 2024.

Who to contact 

If you have questions about the supply of amiloride, contact your wholesaler or the supplier. 

If you have questions about moving patients to an alternative treatment, contact a relevant specialist first.

If you have funding questions, email enquiry@pharmac.govt.nz

Please include as much information as you can about the product (presentation, brand, pharmacode) and who your wholesaler is.

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