Clinic out of your chronic medicine? What you can ask for instead

Public clinics and hospitals in several provinces are short of some chronic medicines, and the DA now wants Parliament's health committee to probe shortages of up to 50 critical medicines. If your clinic says your medicine is out of stock, health officials say you should still leave with treatment, even if it's a different brand, pack size or an approved alternative.

Which medicines are affected?

There is no official public list. The DA says the medicines it has identified include (IOL):

• amlodipine (high blood pressure and angina)
• rosuvastatin (high cholesterol)
• metformin (type 2 diabetes)
• olanzapine (schizophrenia and bipolar disorder)
• pregabalin (nerve pain, seizures and anxiety)
• mebendazole (intestinal worms)

The party has asked for Health Minister Aaron Motsoaledi, the health department, the regulator SAHPRA and industry bodies to brief the committee on the full list, the causes and what is being done.

Where are the shortages?

Gauteng Health has admitted supply problems at public facilities across the province, blaming supplier delays, procurement lead times and changes to medicine contracts (IOL).

In the Western Cape, shortages have dragged on since June. Health MEC Mireille Wenger has written to Motsoaledi asking for national intervention and clear timelines, citing manufacturing and regulatory problems, import and customs delays and slow testing and release of some medicines (Cape Times). The DA says it has also had reports of stock-outs in the Eastern Cape, Limpopo and North West (same source).

KZN Health has linked some disruptions to the conflict in the Middle East (The Star).

What should you do if your medicine is out of stock?

Ask the pharmacist what they can give you instead. Gauteng Health says that when a medicine, strength or pack size runs out, facilities may give you a different pack size or strength, or a clinically appropriate alternative under the approved treatment guidelines (IOL). Stock can also be moved between clinics and districts.

If the pharmacy can't help, you may be sent back to the doctor for a new prescription. "When we ask you to go back to the doctor for a prescription change, don't leave empty-handed or feel unassisted," KZN's provincial pharmaceutical depot manager Thandeka Njapha said (The Star).

KZN Health says facilities are discouraged from sending patients away with private prescriptions they can't afford (same source).

Is a different-looking pill safe?

The National Department of Health says a change in a medicine's colour, shape or packaging doesn't affect its quality or how well it works, because all products must meet the same regulatory standards (The Star). Gauteng Health says medicine from a different approved maker has the same active ingredient, strength and effect (IOL). If you're unsure, ask the pharmacist to check it against your prescription before you stop or change anything.

Can you buy it from a street vendor?

No. Police in the Western Cape arrested a 38-year-old vendor at the Nyanga Junction transport hub on 12 October for allegedly selling medicine from boxes, some of it expired. Police urged the public to buy medicine only from pharmacies and authorised suppliers, and nurses' union Denosa warned that street medicine can put your health at risk (Cape Times).

Was there a recall too?

Yes, separately. In mid-August SAHPRA recalled four batches of Enalapril 10mg Arya, a blood pressure medicine, after out-of-specification test results. The batch numbers are GQQ24053, GQQ24064, GQQ24066 and GQQ24067 (The Star). If your box carries one of those numbers, ask your pharmacist about it.