Clomipramine tablets: Supply issue

Affected product

The supplier of clomipramine tablets, Teva, is experiencing supply issues with clomipramine 10 mg and 25mg tablets. A facility in Poland is no longer able to manufacture the product. It is uncertain whether supply of Clomipramine Teva brand of clomipramine tablets will be available in the future. While this brand may not be available, we are working to make sure clomipramine remains available for people who use it.

• Chemical: Clomipramine hydrochloride
• Brand: Clomipramine Teva

• Presentation: 10 mg tablet 
• Pharmacode: 2611392 

• Presentation: 25 mg tablets
• Pharmacode: 2611406

Clomipramine schedule listing(external link)

Alternative 25 mg tablet listed 1 April 2024

• Brand: Anafranil S29
• Presentation: Tab 25 mg 
• Subsidy $39.97 
• Pack size: 100
• Pharmacode: 2676508 
• Wastage claimable

Alternative 10 mg capsule listed 1 March 2024

• Chemical: Clomipramine hydrochloride
• Presentation: Cap 10 mg
• Brand: Clomipramine Teva
• Subsidy: $9.49
• Pack size: 28
• Pharmacode: 2674149
• Wastage rules apply

Supply status

Tablets remain available with the supplier and the capsules will be available once the tablets have run out. 

Teva and Pharmac are working to ensure a supply of clomipramine remains available for people who need it.

Alternative 25 mg capsule listed 1 November 2023

Teva have sourced stock of Clomipramine Teva capsules as an alternative to the tablets. The capsules were funded from 1 November 2023. This medicine is not Medsafe approved and will need to be prescribed and dispensed in line with section 29 of the Medicines Act.

• Chemical: Clomipramine hydrochloride
• Presentation: Cap 25 mg
• Brand: Clomipramine Teva
• Price: $11.19
• Pack size: 28
• Pharmacode: 2666901
• Wastage rules apply

Supply status

A large shipment arrived mid-February 2024. A further shipment of the capsules has been delayed until July 2024. Teva and Pharmac are working to ensure clomipramine remains available.

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)

Using 10 mg to make up the needed dose

Pharmac understands that tablets cannot be halved. Where possible, pharmacists can make up the needed dose with 10 mg tablets. 

If someone is prescribed a dose of clomipramine that cannot be changed to an equivalent amount of clomipramine 10 mg tablets, they will need to talk to their doctor.

Pharmacist can refer to the Pharmacy Procedures Manual(external link) - see Section 7.14  for the rules when changing the quantity dispensed for a medicine on a prescription where there is extra cost but no change to the total daily dose.

Pharmacists will need to guide people who need to take more tablets to meet their prescribed dose.

On-going availability of clomipramine

People have asked us about the on-going availability of clomipramine. Principal supply status for the Teva brand of clomipramine ends on 30 June 2024. 

We have included clomipramine in our latest Annual Tender. This invites all suppliers to make a bid to supply this product to Aotearoa New Zealand. 

We're committed to making sure clomipramine remains available as a funded treatment for New Zealanders. 

Who to contact

If you take clomipramine, talk with your doctor, nurse, or pharmacist if you have any questions about this supply issue.

If you have other 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.  

Sign up to our email list for regular emails about supply issues and more(external link) 

Need to talk?

Free call or text 1737(external link) any time for support from a trained counsellor.

Lifeline(external link) – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP).

Youthline(external link) – 0800 376 633, free text 234 or email talk@youthline.co.nz or online chat.

Samaritans(external link) – 0800 726 666

Suicide Crisis Helpline(external link) – 0508 828 865 (0508 TAUTOKO).