Temazepam has been out of stock for the last couple of months with no indication of any resupply by the main wholesalers to pharmacies in the UK. Temazepam shortage affects the supply of both temazepam 10mg and 20mg tablets.
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What is temazepam?
Temazepam is a medication used mainly to help with insomnia (short-term use). Temazepam belongs to a group of drugs called benzodiazepines also known as hypnotics. Hypnotics and non-hypnotic drugs are considered short-term relief of insomnia when ‘sleep hygiene’ measures failed and insomnia is not likely to resolve soon (NICE, 2022).
In practice, many patients have been using temazepam for many years, and this group of people will be most affected by the temazepam shortage.
Legal classification and prescription expiry times for temazepam
In the UK, temazepam is classified as a controlled drug schedule 3. Controlled drugs which range from Schedule 1 to 5 have a range of restrictions and legal requirements for the writing of prescriptions and the storage of drugs. For example, one of the distinctive differences between temazepam and other schedule 3 controlled drugs is the storage requirement, which means that temazepam needs to be kept in a controlled drug cabinet (safe).
Most prescription legal requirements for controlled drugs are automatically applied when a drug is issued with the use of an electronic prescription service (EPS) and sent to the pharmacy electronically.
Perhaps the most relevant legal requirement from a patient’s perspective during the shortage of temazepam is prescription expiry times. Prescriptions for temazepam and other controlled drugs expire 28 days from the day they are issued.
Patients who are given a prescription ‘owing’ for temazepam due to lack of stock can only receive a supply of the drug within 28 days of the prescription date. The same law applies to a partly supplied prescription. For example, the patient is given part of the total quantity supplied on prescription. Pharmacy needs to dispense and patients need to collect the remaining balance of the total quantity prescribed within 28 days of the prescription issue date.
After 28 days a prescription for temazepam expires and a supply of the drug cannot be made. This also means that patients who take temazepam regularly, for example, every month, should request it when allowed to do so to maximise the possibility of re-supply when temazepam is back in stock.
What is the latest news on the temazepam shortage?
Update: January 2023
Temazepam is slowly coming back in stock from the main pharmaceutical wholesalers. Patients should see some stock availability in January. Both temazepam 10mg and 20mg are coming back in stock.
The Pharmaceutical Services Negotiating Committee (PSNC) issued a supply notification in mid-September. According to the notification issued temazepam 10mg and 20mg tablets are short (limited) in supply till the beginning of December.
This notification is a bit of an understatement since in recent weeks temazepam 10mg and 20mg are completely out of stock.
Community Pharmacy Scotland (CPS) has issued a more realistic update on the temazepam shortage with limited stock extending till the end of 2022.
I contacted Teva, one of the manufacturers of temazepam 10mg and 20mg tablets and inquired about the temazepam shortage and earliest drug availability. The bland response was that temazepam is long-term out of stock with anticipated resupply in January 2023.
Temazepam alternatives?
Z-drugs alternative to temazepam
One of the most common group non-benzodiazepine hypnotics (Z-drugs) prescribed for the treatment of insomnia are zopiclone and zolpidem tartrate. Although classified as non-benzodiazepine, due to different chemical structures, zolpidem and zopiclone act on the same receptors as benzodiazepines. Z-drugs are preferred over other benzodiazepines as they have a smaller potential to cause dependence (addiction). Z-drugs are preferably prescribed over benzodiazepine to individuals who are over 55 years of age (NICE, 2022).
At the beginning of November, zopiclone became out of stock, most likely temporarily and possibly due to increased demand from the lack of temazepam availability.
Related posts:
- Temazepam vs Diazepam
- Best zopiclone alternative drugs for sleeping
Unlicensed temazepam
As PSNC suggested some wholesalers (like Target Healthcare) which specialise in importing medicines may be able to source temazepam 10mg and 20mg tablets from abroad (unlicensed medication in the UK).
All pharmacies in the UK use ‘special’ wholesalers to fulfil prescriptions for a variety of unlicensed medicines which may be another option for supply for unlicensed temazepam tablets.
Unlicensed medicines carry an additional cost which means a pharmacy would not try to supply unlicensed temazepam on a normal prescription.
Prescribers (GPs) need to issue a prescription for unlicensed temazepam. The prescription should read:
Temazepam 10mg tablets (Special Order) or Temazepam 20mg tablets (Special Order).
Temazepam liquid
Temazepam liquid (Temazepam 10mg/5ml oral solution sugar-free) has been available throughout August, September and October, however, it went out of stock in November, most likely due to supply problems with temazepam tablets. Additionally, temazepam liquid is expensive (around £220 per 300ml of temazepam) which makes it less likely to be prescribed.
Other benzodiazepines
Few other benzodiazepines are licensed in the UK for treatment of insomnia, including:
- Diazepam
- Lorazepam
- Nitrazepam
- Flurazepam
- Oxazepam (insomnia associated with anxiety)
To conclude, the supply of temazepam will be disturbed until January 2023. Patients who currently use temazepam regularly need to contact their GP to get the best alternative prescribed.
Temazepam shortage: FAQ
Is temazepam still available UK?
Temazepam is temporarly out of stock untill January 2023 when expected re-supply to pharmacies in the UK should happen.
What is a good replacement for temazepam?
Individuals who seek replacement of temazepam should contact their GP who may prescribe alternative drugs for example a z-drug like zopiclone or zolpidem. Other replacement drugs include diazepam, lorazepam, nitrazepam and other drugs within the class.
How can I get temazepam?
Temazepam is a prescription only medication (POM). A GP or another qualified prescriber needs to issue a prescription for supply to happen.
References:
NICE (2022). Scenario: Managing short-term insomnia (less than 3 months duration). Available at: https://cks.nice.org.uk/topics/insomnia/management/managing-short-term-insomnia-less-3-months/ Accessed on 05/11/2022.
Hi Michal, I am a patient who has been taking temazepam for the last 15 years. My doctor just carried on happily prescribing it to me week after week. when the shortage happened i was left without, confused as to what was happening. my doctor never even bothered to tell me about the shortage. I researched the problem myself and found that there was liquid temazepam available. it was only the last three weeks that i made my doctor’s surgery issue me with the oral liquid, and now there is no stock of even that available. When i picked up my last prescription last week i was told by the pharmacist that i only had 90 ml instead of my usual weekly dosage of 115m[, taken as 15ml per night. i just want to say that my surgery has caused me so much distress, anxiety and unimaginable grief when they had all the answers but i was the one who had to put in the time and effort to research what to do and what alternetives there were, if any. And even when i did find an alternetive they refused to prescribe it to me. in the end i had no choice but to contact NHS England and complain about them. strangely enough, after i had initially spoken to my key worker ten minutes after hanging up i received a phone call from my doctor wanting to help…As far as i was concerned it was too little to late!
I have had exactly the same problem as you , no help or warning from GP re no temazapam since September 2022 , and the local pharmacy told me , we haven’t any in stock , I had to go back to gp to get another alternative script, with no one helping me to understand what was happening.
Yes , I know the feeling . No info from Doctors about the supply shortage of Tamazepam tablets . I have been on them for 20 years .I had zopiclone instead but it gave me headaches . My chemist said I can get them for you , so the doctor gave me prescription for 14 , and than the chemist would not give me them because they come in 28 pack . So I had a battle to get a Doctor to give me another prescription with 28 . Now I have for 2 days no tamezapam or zopiclone . I am struggling.just waiting the chemist to order them so I can get some . Fingers crossed.