SSP030 Sandrena® 0.5mg and 1mg gel sachets (SUBSTITUTION)

The Department of Health and Social Care (DHSC) has issued a substitution Serious Shortage Protocol (SSP) for Sandrena® 0.5mg and 1mg gel sachets in response to a significant ongoing supply disruption.

This SSP will enable community pharmacists in England, Wales, Scotland and Northern Ireland to supply patients with an alternative product on prescriptions with a treatment duration of three months or less and supplies of either or both strengths are unavailable to fulfil the daily dose, as per the document below, if considered clinically appropriate.

It allows estradiol patches to be supplied against prescriptions for Sandrena® 0.5mg and 1mg gel sachets (written both generically and by brand). The strength of estradiol patch is to be determined by the patient’s current daily dosing regime of Sandrena® 0.5mg and 1mg gel sachets. Due to the nature of the substitution, an exact replication of the duration of treatment may not be possible. Supply must be made to the nearest quantity of patches. See the table below for equivalent products, strengths and quantities to supply:

Current dose of Sandrena	Equivalent Dose of estradiol patch	Patch options	Dosing	Quantity to supply
500microgram estradiol daily (1 x 500microgram sachet daily)	25 microgram patch	Evorel®	Apply one patch TWICE WEEKLY	For every 7 x 500microgram gel sachets supply 2 Evorel® patches
1mg estradiol daily (2 x 500microgram sachets OR 1 x 1mg sachet)	50 microgram patch	Progynova TS®	Apply one patch WEEKLY	For every 14 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets where only 1mg gel sachets are prescribed supply 1 Progynova TS® patch
		FemSeven®	Apply one patch WEEKLY	For every 14 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets where only 1mg gel sachets are prescribed supply 1 FemSeven® patch
		Evorel®	Apply one patch TWICE WEEKLY	For every 14 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets where only 1mg gel sachets are prescribed supply 2 Evorel® patches
		Estraderm MX®	Apply one patch TWICE WEEKLY	For every 14 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets where only 1mg gel sachets are prescribed supply 2 Estraderm MX® patches
1.5mg estradiol daily (3 x 500microgram sachets OR (1 x 1mg sachet and 1 x 500microgram sachet)	75 microgram patch	FemSeven®	Apply one patch WEEKLY	For every 21 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets AND 7 x 500microgram sachet where both 500microgram and 1mg gel sachets are prescribed supply 1 FemSeven® patch
		Evorel®	Apply one patch TWICE WEEKLY	For every 21 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets AND 7 x 500microgram sachet where both 500microgram and 1mg gel sachets are prescribed supply 2 Evorel® patch
		Estraderm MX®	Apply one patch TWICE WEEKLY	For every 21 x 500microgram gel sachets where only 500microgram gel sachets are prescribed OR For every 7 x 1mg sachets AND 7 x 500microgram sachet where both 500microgram and 1mg gel sachets are prescribed supply 2 Estraderm MX® patch

In accordance with an SSP for a substituted product, if the patient normally pays for their prescriptions, they will still have to pay the usual prescription charge.Please refer to the SSP document for information on advice on counselling points to make the patient aware of in relation to monitoring and managing potential side effects and other issues

SSP030 for Sandrena® 0.5mg and 1mg gel sachets will be in operation from Friday 20th May 2022 until Friday 27th January 2023 (UPDATED EXPIRY DATE).

Please note that the SSP may be amended or revoked at any time, so contractors must ensure that the SSP is still valid before each supply.

Sandrena® 0.5mg and 1mg gel sachets SSP030

Serious Shortage Protocol SOP