Advanz Pharma, the supplier of hydrocortisone sodium phosphate, has confirmed that due to manufacturing issues they are currently unable to supply the liquid hydrocortisone for emergency injection kits and expect to resume supply by Q2 2023. 

In some parts of the UK your pharmacist may still be able to locate some of the remaining stock. However please be advised that you will need to order the alternative form, ‘Hydrocortisone 100mg Powder for Solution for Injection or Infusion 1x2ml - vial with diluent’ (previously known as Solu-Cortef), if renewing supplies for your emergency injection kit until early next year. 

What does this mean for people with Addison’s and adrenal insufficiency?

Anyone who needs to renew their injection kit materials will have to ask their GP to issue a prescription for the alternative form of injectable hydrocortisone. For NHS prescriptions it is necessary to give the generic name which is: 

• Hydrocortisone 100mg Powder for Solution for Injection or Infusion 1 x 2ml (vial with diluent) - previously known as Solu-Cortef.
• Members outside the UK (Ireland, Europe and Americas) may also be able to obtain the Act-o-Vial preparation, containing hydrocortisone sodium succinate and water in a chambered ampoule. 

Positively, hydrocortisone sodium succinate (Solu- Cortef) is more stable in hot weather (above 25ºC) so this may be a prudent choice for those planning a trip abroad.

Guidance for GPs on what to prescribe can be found in the GP Care leaflet.

Practise makes perfect - training in using the Hydrocortisone injection

The Hydrocortisone 100mg Powder for Solution (previously known as Solu-Cortef), being a powder and water, needs to be mixed on the spot prior to use.

If you are switching to Hydrocortisone 100mg Powder for Solution for the first time, it is advisable to ask your GP or practice nurse to show you how to do this, preferably with a loved one so they can also learn. Some people find they need to ask someone for help in preparing the hydrocortisone injection syringe when they are unwell, so by having a loved one also educated in how to use the injection, if needed in an emergency that person can then hand you the prepared syringe to self-inject, or do it for you.

You can also watch our ‘How To’ videos on our YouTube channel and use our written guidance (picture instructions) in your kit.

Can I pre-prepare my Hydrocortisone injection?

If you find the powder solution fiddly to prepare, some people prefer to keep a dated syringe permanently made up in the fridge, ready to use in an emergency. This should be discarded after 80 days. 

It is important your pre-loaded plastic syringe, with a made-up solution of Hydrocortisone (previously known as Solu-Cortef) in it, is clearly labelled by yourself to record its 80 day best-by date and it is kept in a light proof box (you can wrap some paper towel around the box to achieve this).

• Stability of Solu-Cortef research paper: Rigge DC, Jones MF. Shelf lives of aseptically prepared medicines--stability of hydrocortisone sodium succinate in PVC and non-PVC bags and in polypropylene syringes. J Pharm Biomed Anal. 2005 Jun 15;38(2):332-6. doi: 10.1016/j.jpba.2004.12.026. PMID: 15925227.

How long will this manufacturing issue last?

They are expecting new batches by Q2 2023. In some parts of the UK, your pharmacist may still be able to locate some of the remaining stock. 

Support

If you do have any concerns about your condition it is very important to speak to your GP surgery or endocrine healthcare team. We are also here to support you. If you are confused or worried about drug shortages, we've put together a guide to support you.

Drug Shortage Coping Strategies 

If you feel you need more emotional support during this time, click here to read our reducing the stress of a long-term condition page. If you would like to speak to others with Addison's disease and adrenal insufficiency, our online forum is here for you 24/7. Click here to speak more with our community.

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