Some members have been in touch to report issues with Accord 10mg hydrocortisone tablets crumbling when split. Understandably, this makes people concerned they are not receiving the right dose.
Not all people with steroid-dependency receive this brand of 10mg hydrocortisone tablets, so this may not impact you. However if you are having issues with your Accord 10mg tablets, please:
- Report via the Yellow Card Scheme
- Report to Accord (the manufacturer) as the crumbling may indicate a batch issue. You will be asked for the batch number on the tablet box, so have these details to hand. You can report via their website here, or email: medinfo@accord-healthcare.com
Individual reports are important as the more evidence submitted, the more seriously this issue is taken.
Statement from Accord-UK Ltd & Next Steps
ADSHG has followed up on this issue with Accord-UK Ltd, who have provided a full statement.
In summary, they have acknowledged a quality issue, notified the Medicines & Healthcare products Regulatory Agency (MHRA), and, following a full assessment, it was agreed that a product recall was not required due to the potential impact on market supply.
If you are affected, the current recommendation remains that you should discuss one of the following options with your GP:
- Add a note on your repeat prescription specifying that Accord 10mg tablets should not be dispensed by your pharmacy and that an alternative manufacturer should be used instead.
- Add lower-dose hydrocortisone tablets to your repeat prescriptions so you do not need to split 10mg tablets.
To support you in this conversation, we have created a one-page document for you to take or send to your GP, to explain the known quality issue with some Accord 10 mg hydrocortisone tablets, and includes Accord's full statement.
It provides your GP with the information needed so you can then request either a different brand of hydrocortisone or a prescription for lower-dose tablets to avoid splitting the Accord hydrocortisone 10mg tablets whilst this known quality issue continues.
A clinical need for lower dose tablets
Apart from the issue with Accord-UK 10mg tablets, there are groups of people with steroid-dependency where prescribing 2.5mg and/or 5mg tablets is clinically justified and appropriate. These include:
- People who cannot reliably split tablets, such as due to poor dexterity, visual impairment, or cognitive difficulties.
- Children and young people who need accurate doses and may feel self-conscious about splitting tablets at school or with their peers, which can make it hard for them to keep to their medication regimen and up-dose.
- Patients who are very dose-sensitive, including those who experience symptoms with small dose changes.
- Patients advised by their endocrinologist to avoid tablet splitting or brand changes.
If you would like your GP to add lower-dose tablets to your repeat prescriptions, here are some tips to help you show your clinical need and support your conversation:
- Highlight your clinical need for lower doses: especially if you have dexterity, visual impairment, or cognitive difficulties, have trouble taking your medicine throughout the day as prescribed, or have been advised by an endocrinologist.
- Explain your symptoms clearly: let your GP know if you are experiencing fatigue, dizziness, or other changes when splitting tablets.
- Mention any difficulties splitting tablets: including crumbling or uneven dosing.
- Request a certain hydrocortisone brand: if a certain brand is easier for you to split, discuss with your GP if they could add a note on your repeat prescription that this brand of 10mg tablets should be supplied by the pharmacy.
- Bring documentation: print out our support document to discuss with your GP, or any endocrinology advice, as this helps your GP make informed decisions.