Lorazepam 1 mg tablets restricted by supply issues

Pharmac has informed healthcare professionals that the supply of lorazepam (branded as Ativan), from supplier Aspen, will be disrupted due to supply issues. This disruption to New Zealand’s supply of lorazepam 1 mg tablets is a result of supply chain logistic challenges.

“The supplier of 1 mg tablets of lorazepam – a medicine generally used short term to manage anxiety and sleep problems – has advised Pharmac that there is only two weeks supply of this medicine in the country. We expect that this medicine will be resupplied to New Zealand in early to mid-August,” said Pharmac’s Director of Operations Lisa Williams. “This means that the shortage will affect those who need a prescription of lorazepam 1 mg tablets dispensed within the next 2-4 weeks.”

“While no direct chemical substitute is available, we have been working to help ensure the remaining stock is distributed as fairly as possible. Yesterday we advised pharmacies that they should only dispense a week’s supply at a time of lorazepam 1 mg to patients - this is to ensure equitable distribution amongst patients. This dispensing rule will be in place until 31 August 2022,” says Ms Williams. “Aspen has advised us that it expects supply of lorazepam 1 mg tablets to have resolved by mid-August 2022,” said Ms Williams.

Pharmac’s expert clinical advisors have reinforced the importance of continuity of supply for this important medicine. Although they note that most people would only be using lorazepam for short periods of time (i.e. a few days to four weeks).

“Some clinicians may consider transitioning patients to half a 2.5 mg tablet - which is scored for simpler halving. However, of course this would be an increase in dose-per-tablet (from 1mg to 1.25mg), so would be a matter of clinical judgement about appropriateness. This would require a new prescription,” said Ms Williams.

“We know supply disruptions can be distressing for people. We are continuing to work with our suppliers to secure an alternative supply of the 1 mg lorazepam and have also sought clinical advice on alternative treatments. Our clinical advisors have informed us that there are alternative treatments but transitioning people from lorazepam 1 mg to an alternative treatment will require clinician involvement. People will need to speak to their GPs, who can advise them on the best possible option for them.”

“We know this is not ideal with an already stretched health system, but it’s important we alert clinicians, pharmacists, and the public about supply issues as soon as we are able.”

Pharmac’s contract with Aspen requires it to hold at least two months’ supply of any medicine it supplies to New Zealand. Pharmac will be investigating why this obligation has not been met.

Pharmac will continue to update the healthcare sector and public and will keep our website up to date. Supply issues are something that Pharmac is continually monitoring.