Amiodarone, a medication used to treat heart rate and rhythm disorders, has been largely absent from pharmacies for several months. Many patients who rely on this drug are retirees and find it difficult to monitor its availability online.
A crucial medication for patients with arrhythmia has been practically unavailable in pharmacies for several months. This is amiodarone, used to treat heart rhythm disorders. Specifically, the issue concerns tablets. According to online pharmacy data, the concentrate for intravenous injection solution is available. However, this form is not recommended for home use according to instructions. Maxim, a doctor and head of a department in a hospital near Moscow, shared his perspective:
Yesterday, a relative from Tyumen contacted me. Her mother was prescribed amiodarone, or Cordarone – they are the same active substance, just different names. They can`t find it anywhere, neither in Tyumen nor the surrounding region. Her doctor told her to find it wherever she could, so she called me. I started searching in Moscow and the Moscow region; it`s not available in pharmacies. Not online, not in physical pharmacies, not at warehouses. I asked the pharmacist at my hospital, and she said there are no tablets, and suppliers don`t have them in stock either. There have been no informational letters explaining why this drug hasn`t been supplied. I spoke to the head of the cardiology department, explaining the situation. She said, yes, there is such a problem; the drug is not available anywhere, don`t even bother looking, you won`t find it anywhere except perhaps abroad, including Belarus. The price of the drug, according to the price lists I found, is around 200 rubles. Why this situation occurred is unclear. Especially considering this drug is on the list of vital and essential medications.
In Moscow, based on pharmacy websites, tablets can be found in just a few pharmacy points across the city. However, it`s worth noting that many patients taking amiodarone are pensioners. They have difficulty monitoring websites to track when and where the drug appears. Is it widely prescribed? Muraz Shambatov, a cardiologist and associate professor at the Department of Pharmacology and Clinical Pharmacology at the Ural State Medical University, explains:
Cardiologist, Associate Professor
Overall, amiodarone is a class III antiarrhythmic and is quite frequently prescribed to patients with atrial fibrillation, both for rhythm restoration and for maintaining a target heart rate. The drug has somewhat lost its significance now, there are alternatives, but there is still a specific cohort of patients who receive amiodarone, and the departure of Cordarone from the market will be noticeable. Generally, generic drugs with the same active substance are registered in the state register of medicinal products, and generic drugs can be considered a complete alternative here. Therefore, Cordarone`s departure from the market is sensitive, but nevertheless, I think it`s a solvable problem.
In 2019, drugs containing amiodarone also disappeared from Russian pharmacy shelves; at that time, a disruption in supplies from the French manufacturer Sanofi, which produced the drug under the name «Cordarone,» was blamed. But now, it seems neither the foreign version nor the Russian drug containing amiodarone – produced, for example, by the domestic pharmaceutical company Organika – is available.
Several months ago, when the shortage first emerged, the newspaper Izvestia wrote that the reason was re-registration, as the Ministry of Health recommended introducing changes to the instructions for such medications. There are quite a few analogues, as explained to Business FM by Nikolay Bespalov, development director at the analytical company RNC-pharma:
Development Director, RNC Pharma
There is a problem with Cordarone; the drug is supplied to Russia by the French company Sanofi. There is indeed a problem with supplies, and to understand the scale of the issue, in the current year, over the first almost six months, 45.6 thousand packages were imported. Previously, more than 110-140 thousand packages were imported every month. The problem is evident and is related to some difficulties with supplies. Most likely, the problem is related to the fact that the drug is on the list of vital and essential drugs, and the company cannot quickly index its prices. This is at least one of the most probable hypotheses, although purely technical problems related to equipment malfunctions or disruptions in raw material supplies or other reasons are also possible. As for Russian analogues, they exist, and there are quite a large number of them. The production volumes of these drugs are growing, and the range is quite large. Technically, there should be no problem with replacement here.
However, doctors note that patients should not replace the drug themselves. This is because amiodarone`s elimination period from the body can be several weeks. If one antiarrhythmic drug is layered upon another, the consequences can be unpredictable. Furthermore, it is necessary to ensure that the replacement drug is not contraindicated for the patient.
