Lithium carbonate (Lithicarb FC): Discontinuation

Discontinuation Active

Lithium carbonate (Lithicarb FC) 400 mg tablets and 250 mg (Lithicarb FC) tablets are no longer available. 

Prescribers will need to:

  • ensure all patients on (Lithicarb FC) 400 mg tablets have been changed to 250 mg capsules (Douglas) or 400 mg LA tablets (Priadel); and
  • transition all patients who are on 250 mg (Lithicarb FC) tablets to 250 mg capsules (Douglas) or 400 mg LA tablets (Priadel). All patients on 250 mg tablets will need to move to the different products.  

Priadel brand remains available

PHARMAC understands that the Priadel brand is being discontinued in the United Kingdom. This will not impact the New Zealand supply of Priadel.

What are the funded treatment options?

The clinical advice PHARMAC has received is that patients can be changed to the other funded lithium carbonate presentations of 400 mg LA tablets or the 250 mg capsules. The 400 mg LA tablets are scored and can be halved if necessary, to achieve the required dose of lithium carbonate. 

As with any change to lithium, patients will require monitoring of serum lithium concentrations during the change. In general, serum lithium concentrations should be performed weekly after each dose change until concentrations are stable, then every 3 months thereafter.

More information regarding serum lithium concentrations and monitoring following a change in dose can be found on the New Zealand Formulary(external link).

This has been summarised into the table below:

Lithium products affected

Availability

Funded alternative lithium products

Monitoring

250 mg tablet

Stock ran out at the end of April 2020

Lithium carbonate 250 mg capsules (and/or 400 mg LA tablets if appropriate)

Serum lithium concentrations  need to be checked after changing to another lithium product - refer to NZF for more information.(external link)

400 mg tablet

There is no longer stock available

All patients should have been changed to lithium carbonate 250 mg capsules or 400 mg LA tablets

Serum lithium concentrations  need to be checked after changing to another lithium product - refer to NZF for more information.(external link)

Why did this happen?

The supplier of lithium carbonate 250 mg and 400 mg film-coated tablets (Lithicarb FC brand) informed PHARMAC it could no longer supply these tablets in New Zealand.  

There are no changes to the availability of lithium carbonate 400 mg LA (long acting) tablets (Priadel brand) or lithium carbonate 250 mg capsules (Douglas brand) – these both remain funded. 

People taking lithium carbonate tablets will need to talk to their health care professional about alternative brands of lithium carbonate.

Where can I get more information?

If you have any questions, please contact PHARMAC at 0800 660 050 or enquiry@pharmac.govt.nz