Circular 13 April 2026: Biperiden 5mg per ml Injection 1ml - Stock Supply Shortage and the Proposed Therapeutic Alternative
The Adult Hospital Level (AHL), Paediatric Hospital Level (PHL), and Primary Healthcare (PHC) Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) 1,2,3 currently recommend biperiden injection as a treatment option for acute dystonic reactions. The contracted supplier of biperiden injection, Pharmaco Distribution (Pty) Ltd, is experiencing supply constraints with this product.
The Adult Hospital Level (AHL), Paediatric Hospital Level (PHL), and Primary Healthcare (PHC) Standard Treatment Guidelines (STGs) and Essential Medicines List (EML)1,2,3 currently recommend biperiden injection as a treatment option for acute dystonic reactions. The contracted supplier of biperiden injection, Pharmaco Distribution (Pty) Ltd, is experiencing supply constraints with this product.
There are no alternative injectable anticholinergic antiparkinson agents (e.g., benztropine injectable solution) available in South Africa. It is therefore recommended that promethazine injection (IM) be utilised as an alternative to biperiden injection for this indication, where biperiden injection is unavailable. Refer to the table in the document below for further guidance.