DiphenhydrAMINE Injection Shortage 10.15.18

To:            Physicians, Nursing, Pharmacy

From:     Maryna Shayuk, MD, Chair Pharmacy and Therapeutics

                  Alan Mader, Pharmacy Operations Coordinator

Date:        October 15, 2018

Re:            Diphenhydramine Injection Shortage

S

Situation

Diphenhydramine injection supply is critically low. Estimates indicate less than a 2 week supply throughout NM Northwest system.
B

Background

Diphenhydramine has been on shortage. Pharmacy Purchasing has been able to obtain orders up to this point.
A

Assessment

In order to maintain the limited supply for crash cart exchange, sequestering to pharmacy and therapeutic substitution will need to be instituted.
R

Recommendation

Pharmacy will sequester remaining supply from Pyxis machines to the Pharmacy Department.   Therapeutic Substitution will take place as follows:

Injection to PO – For all patients who can take PO in equivalent dose.

If unable to take PO – Therapeutic substitution to Promethazine Injection in equivalent dose.   Doses greater than 25 mg – consult with MD.