Drug Safety Bulletin: Drug Shortages-May 2015 Save

Jack Cush, MD

May 11, 2015 12:21 pm

Drug Safety Bulletin: Drug Shortages

You make the command decision or the patient investigates the risks and benefits and the optimal agent is chosen. You have hope, the means to acquire the medicine and then BAM - you get derailed by a drug shortage. Drug shortages are frequent, may involve vaccines and biologics, but most commonly involve generics. Hence this problem is magnified in the elderly on Medicare and those without insurance.

The Rheumatologist reviewed this issue in 2011 (http://url.ie/yzy5). In some instances, you can circumvent the problem with alternative forms of the same or similar drug or prescribe different dose forms. If the shortage is protracted, alternative choices, with their risks and cost, must be sought.

RheumNow will bring you monthly reports of Drug Shortages as part of its regular Drug Safety Bulletin reports. If you have suggestions or information about specific drug shortages or drug safety issues, please email us at: info@rheumnow.com .

Reported Drug Shortages as of May 1, 2015

Drug Shortage	Reason for shortage	Estimated Availability
Acetaminophen #3 (300/30 mg codeine)	Market conditions	Late May 2015
Azathioprine injectable (100 mg vials)	Prev. maker bought out. No plans to make or promote IV AZA.	Unknown
Azathioprine tablets (50 mg)	Problems obtaining active ingredient.	Early May 2015
Chloroquine tablets (250, 500 mg)	Two makes D/C making chloroquine tablets. Another has shortage due to 3rd party supply issues.	Unclear but West-Ward has chloroquine tablets available with short expiration dating (July 2015). Unable to estimate a release date for additional supplies.
Dexamethasone injection (4mg/ml)	Manufacturing delays, demand issues	Early to late May 2015
Hydroxychloroquine tablets (200 mg)	Company buy-outs, regulatory issues, increased demand	HCQ on back order; possibly mid May 2015
Lidocaine injection, 1%, 2% (2 ml, 5 ml, 10 ml vials)	Manufacturing delays, increased demand	Late May 2015
Methotrexate injection 25 mg/ml (2ml, 10ml, 40 ml vials)	Fewer makers, manufacturing delays	Sandoz “not till 2016”; Accord has 2 ml vials with short expiration date 2/16); Mylan “on back order with no estimated release date”.
Pantoprazole tablets (20 mg, 40 mg)	Fewer makers, increased demand	On back order with no estimated release date
Tacrolimus tablets (0.5, 1.0, 5 mg)	Fewer makers, manufacturing delays	Mid May 2015
Source: http://www.ashp.org/DrugShortages/Current http://www.accessdata.fda.gov/scripts/drugshortages/default.cfm