Drug shortage

updated 9.28.17

Please review this report in its entirety.  Unfortunately, shortages and allocations are affecting many products at Centegra hospitals.  The Pharmacy Purchasing team is working hard at procuring stock and/or alternatives during these shortages.  Your help and patience is greatly appreciated.

Medication / Descripton Description Duration / Resolution Date Alternative / Risk Mitigation Strategy
albuterol INH 90 mcg/actu 8 GM 10/10/2017 receiving allocation as available from Cardinal; check stock and if 8 GM unavailable; switch to 18 GM 18 GM inhaler brought in during shortage; under separate charge code
amiodarone inj 50 mg/mL 18 mL SDV no date provided although still on backorder, allocation available 9/27/17 increased stock of 50 mg/3 mL vials during shortage
atropine syringe 1 mg/10 mL syringe late December although still on backorder, available 9/27/17 During shortage, we may receive the syringe product with needle attached. Attach a “CAUTION – NEEDLE ATTACHED” label to these products in any carts or kits
atropine vial 1 mg/mL SDV no date provided
benzocaine (AMERICAINE) topical aerosol 57 GM no date provided DERMOPLAST would be alternative
bupivacaine-epinephrine PF 0.25%-1:200,000 inj 30 mL no date provided 10 mL size also on backorder
bupivacaine-epinephrine PF 0.25%- 1:200,000 inj 10 mL no date provided no alternatives available 30 mL has been procured direct from Fresenius Kabi
bupivacaine-epinephrine PF 0.5%-1:200,000 inj 10 mL no date provided no alternatives available 30 mL has been procured direct from Fresenius Kabi
bupivacaine-epinephrine PF 0.5%-1:200,000 inj 30 mL no date provided 10 mL size also on backorder;
calcium chloride 1 GM/10 mL syringe manufacturer is allocating although still on backorder, alternative available with allocation 9/27/17 During shortage, we may receive the syringe product with needle attached. Attach a “CAUTION – NEEDLE ATTACHED” label to these products in any carts or kits
calcium chloride 10% 1 GM/10 mL vials date not provided
calcium gluconate 10% 50 mL vial no date provided alternative available with allocation 9/27/17 10 mL stocked
cefotaxime (CLAFORAN) 1 GM 4/4/2018 PEDS RESTRICTED CHM 75 vials/CHH 70 vials each 9/27/17
D5%-0.45% Sod Chlor 1000 mL no date provided although still on backorder, allocation available 9/27/17 see SBAR if stock is depleted
D5%-0.9% Sod Chlor 1000 mL no date provided although still on backorder, allocation available 9/27/17
D5%-Lactated Ringers 1000 mL no date provided although still on backorder, alternate available with allocation 9/27/17
diazepam inj 10 mg/2 mL carp no date provided CHM has supply of 50 mg/10 mL MDV if needed to draw syringes; lorazepam is alternative; move stock around in Pyxis as needed
diltiazem inj 100 mg ADDV vials late December compound with 5 mg/mL 5 mL, 10 mL, or 25 mL; whichever is available during shortage SEQUESTER ANY ADDVANTAGE VIALS FOR USE IN ER
dipyridamole 50 mg/10 mL SDV 4/2/2018
dorzolamide-timolol (COSOPT) 2-0.5% ophth drop 10 mL 10/3/2017 we do stock dorzolamide 2% and timolol 0.5% drops individually
doxycycline 100 mg inj 11/6/2017 although still on backorder, allocation available 9/27/17
empty PAB bags 150 mL NON DEHP for ATIVAN drips no date provided B Braun has no release date for this product; use 250 mL NON DEHP bags = Baxter bag # 2J8002
EPINEPHrine syringe 1 mg/10 mL syringe late December See communications via email for most recent update **use up short dated syringes with EMS or other departments to avoid waste** During shortage, we may receive the syringe product with needle attached.  Attach a “CAUTION – NEEDLE ATTACHED” label to these products in any carts or kits
etomidate syringe 40 mg/20 mL syringe no date provided single dose vials are available with allocation
fentanyl inj 250 mcg/5 mL amp late November alternative SDPF vial 3695657
fentanyl inj 1000 mcg/20 mL amp no date provided although still on backorder, alternate available with small allocation 9/27/17
fentanyl inj 2500 mcg/50 mL SDPF late December no alternatives available at this time (4726188)
flurbiprofen ophth 0.03% 2.5 mL ophth drop 10/24/2017 no alternate manufacturers or sizes in Epstein & Rhee eye kits placed a backorder with Cardinal & Smith Med Partners physicians agreed to use ketorolac 0.5% ophth drops (non formulary) when depleted; blanket approval from Dima Awad for this substitution
furosemide inj 40 mg/4 mL vial late November alternate available with allocation 9/27/17 (1454891)
heparin inj 2000 unit/2 mL vial no date provided
hepatitis B vaccine (peds/adol) (RECOMBIVAX HB) 5 mcg/0.5mL sdpf expected 2018 Merck is having a supply issue with RECOMBIVAX HB vials & syringes; release is not expected until 2018 ENGERIX B 10 mcg/0.5 mL will be stocked until it comes back in supply
labetalol INJ 5 mg/mL 40 mL no date provided although still on backorder, allocation available 9/27/17 if out of 40 mL, please use the 20 mL
labetalol syringe 20 mg/4 mL syringe no date provided purchased from Nephron Outsourcing; watch expiration dates! sequester usage per Alan’s instructions, OB & OR only
lidocaine 2% syringe 100 mg/5 mL syringe late December During shortage, we may receive the syringe product with needle attached. Attach a “CAUTION – NEEDLE ATTACHED” label to these products in any carts or kits
lidocaine jelly 2% jelly 5 mL tube allocating 30 ml tube is stocked
lidocaine-epinephrine inj (pf) 2%-1:200,000 20 mL date not provided all lidocaine 1% & 2% -epi products are on backorder check other lido-epi products; receiving some direct shipments from manufacturer
lidocaine-epinephrine inj 1%-1:100,000 20 mL 10/17/2017 all lidocaine 1% & 2% -epi products are on backorder check other lido-epi products; receiving some direct shipments from manufacturer
lidocaine-hyalur AC-Aloe-Coll (REGENECARE HA) 2% gel 85 GM 10/18/2017 allocation available 9/27/17
mannitol inj 25% 50 mL vial late December
meperidine 25 mg syringe date not provided meperidine 50 mg are currently available & stocked; load to Pyxis as appropriate as alternative NOTE – should only be used for rigors with limited use for pain indications
methylene blue 1% SDV 1 mL date not provided loaded in select Pyxis machines methylene blue 0.5% (PROVAYBLUE) brought into stock during shortage; ampules and filter needles will be stocked together in SURGERY CORE Pyxis machines only
metoclopramide 10 mg/2 mL inj early October use PO when possible
metronidazole-NS 500 mg/100 mL IVPB late December
morphine inj (DURAMORPH) 10 mg/10 mL PF amp 3/5/2018 morphine PF 0.5 mg/mL 10 mL is alternative 73010566
octreotide inj 500 mcg/1 mL INJ 10/30/2017
pantoprazole inj (PROTONIX) 40 mg PWVL 10/11/2017 available with allocation 9/27/17; backorder shipments being received esomeprazole (NEXIUM) 40 mg inj will be brought in if our supply is depleted
potassium phosphate 4.4 mEq/mL 5 mL no date provided SUFFICIENT STOCK; although still on backorder, alternate $$$ available with 9/27/17 when out of stock, consider potassium phosphate
potassium phosphate 3 MMOL/mL 15 mL late December although still on backorder, allocation available 9/27/17 5 mL stocked when out of stock, consider potassium phosphate
rocuronium bromide 50 mg/5 mL inj no date provided although still on backorder, alternative available 9/27/17 vecuronium is alternative
sodium acetate 40 mEq/20 mL single dose vial late December alternative to Sodium Bicarb use sodium bicarb syringes when sodium acetate supply is depleted
sodium bicarbonate PED syringe 4.2% 10 mL syringe no date provided sufficient supply at each campus at this time
sodium bicarbonate syringe 8.4% 50 mL syringe late December suppy for use in IV room compounding obtained through Nephron Outsourcing; do not load these to Pyxis at this time SEQUESTER ALL MFR BOXED SODIUM BICARB INJ FOR CRASH CARTS; REPLACE CRASH CART TRAYS WITH ONE SYRINGE INSTEAD OF TWO DURING SHORTAGE During shortage, we may receive the syringe product with needle attached. Attach a “CAUTION – NEEDLE ATTACHED” label to these products in any carts or kits
sodium bicarbonate 8.4% 50 mL VIAL late December Pfizer is releasing only through wholesalers; placed on backorder with Cardinal SEQUESTER ALL SODIUM BICARB INJ FOR CRASH CARTS
sterile talc (SCLEROSOL) 4 GM aerosol powder no date provided low usage item share between campuses as needed 8/29/17 not available & no date for release 5 GM sterile vials now on backorder
sucralfate 1 GM tablet no date provided bottle of 100 available 9/27/17
theophylline 100 mg tab ER 12 hour no date provided 300 mg tab ER 12 hr, 100 mg capsule ER 24 hour & 80 mg/15 mL oral soln is available & stocked
tobramycin ophth drops 0.3% 5 mL drop 10/12/2017 higher priced alternative allocated 9/27/17
tobramycin powder 1.2 GM PWVL 10/2/2017 allocation available 9/27/17
vancomycin inj 10 GM vial late December higher priced alternative available 9/27/17
vecuronium 10 mg vial no date provided although still on backorder, alternative available with allocation 9/27/17
water sterile for inj 50 mL vial no date provided allocation available 9/27/17
BAXTER PRODUCTS – allocated due to hurricane – Pharmacy Purchasing will watch daily and procure as quickly as possible      
amino acids (CLINIMIX) CHM weekly allocation (Baxter) x 1
ceFAZolin IVPB 2 GM frozen 2G3508 CHH weekly allocation (Baxter) x 8 CHM weekly allocation (Baxter) x 13
Empty NON-DEHP 250 mL Bag CHH weekly allocation (Baxter) x 1 CHM weekly allocation (Baxter) x 1
Lactated Ringers 500 mL IV no date provided CHH weekly allocation (Baxter) x 1 CHM weekly allocation (Baxter) x 1 allocation available 9/13/17 use Lactated Ringers 1000 mL bags as alternate
Lactated Ringers 1000 mL IV CHH weekly allocation (Baxter) x 8 CHM weekly allocation (Baxter) x 15
NS 0.9% IV 50 mL CHH monthly allocation (Baxter) x 1 (MINI) CHM monthly allocation (Baxter) x 1 (MINI)
NS 0.9% IV 100 mL
NS 0.9% MINI BAG PLUS 50 mL MINI BAG PLUS date not provided CHH monthly allocation (Baxter) x 2 (MINI PLUS) CHM monthly allocation (Baxter) x 3 (MINI PLUS)
NS 0.9% MINI BAG PLUS 100 mL MINI BAG PLUS date not provided
NS 0.9% IV 250 mL date not provided CHH weekly allocation (Baxter) x 1 CHM weekly allocation (Baxter) x 1
NS 0.9% IV   500 mL date not provided CHH weekly allocation (Baxter) x 3 CHM weekly allocation (Baxter) x 2 MUST HAVE Baxter product FOR CHM OPEN HEART Pharmacy to use other manufacturers bags for compounding as available
NS 0.9% IV 1000 mL CHH weekly allocation (Baxter) x 39 CHM weekly allocation (Baxter) 85
NS 0.9% IRRIG 1000 mL BOTTLE CHH weekly allocation (Baxter) x 12
PLASMA-LYTE A Inj PH 7.4 CHH weekly allocation (Baxter) x 1 CHM weekly allocation (Baxter) x 7
potassium chloride 20 mEq/50 mL CHM weekly allocation (Baxter) x 1
Vial-Mate Adapter no date provided CHH weekly allocation (Baxter) x 1 CHM weekly allocation (Baxter) x 1