Dosulepin [dothiepin] hydrochloride (Dopress brand): Discontinuation

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What's changing?

The supplier of dosulepin [dothiepin] hydrochloride (Dopress) tablets and capsules was no longer able to to supply dosulepin tablets and capsules in New Zealand.  

This means dosulepin will no longer be funded once the current supply ran out. Supplies of dosulepin were exhausted in 2019 and early 2020. 

People taking dosulepin needed to talk to their health care professional about alternative treatments.

Prescribers needed to:

  • ensure no new patients are started on dosulepin
  • start transitioning patients currently on dosulepin on to alternative treatments.

Dosulepin [dothiepin] hydrochloride is a tricyclic antidepressant used primarily for depression of any aetiology and the anxiety frequently associated with depressive illness. Approximately 5,000 patients are using the 25 mg capsule presentation and a further 2,200 patients use the 75 mg tablet presentation. Patient numbers have been declining over time in preference for other antidepressants. 

When will this happen?

  • June 2019 – Dosulepin 25mg capsules was no longer available
  • January 2020 – Dosulepin 25 mg capsules was delisted from the Pharmaceutical Schedule
  • June 2019 – Dosulepin 75mg tablets was no longer funded for new patients
  • August 2020 – Dosulepin 75 mg tablets were delisted from the Pharmaceutical Schedule.

What are the funded treatment options?

The clinical advice we received from the Mental Health Subcommittee of the Pharmacology and Therapeutics Advisory Committee (one of our expert clinical advisory committees) is that amitriptyline or nortriptyline would be appropriate alternatives for patients requiring dosulepin [dothiepin] hydrochloride; imipramine or mirtazapine could also be considered for some patients.

The full list of funded agents available for depression and anxiety is available here.  

Information for prescribers about changing patients

Bpacnz has published information the role of medicines in the management of depression in primary care which may be useful: https://bpac.org.nz/2017/depression.aspx(external link).   

Where can I get more information?

If you have any questions, please contact PHARMAC at 0800 66 00 50 or enquiry@pharmac.govt.nz.