Special Notice Fall 2017, Last Update June 2018
After the impact of the hurricane on Puerto Rico September 2017, pharmacy has been experiencing multiple shortages beyond normally expected however many of those hurricane related shortages have been resolving.
Other shortages unrelated to the Hurricane include Bupivacaine, Lidocaine, Ondansetron, Potassium Chloride concentrated, DOPamine, DOBUTamine, Aminophylline, Calcium Gluconate, Magnesium Sulfate, EpiPens and multiple IV narcotics/controlled substances (DiazePAM, FentaNYL, HYDROmorphone and Morphine). Narcotic and controlled substances are due to upgrades and shut downs at some manufacturing plants (e.g. Pfizer) with shortages continuing through 2018 until 2019.
Pharmacy will post information as this continues to develop. Oral therapy MUST be considered with significant injection/infusion shortages. Guidance will be provided in the Electronic Medical Record with possible alternatives when necessary.
ORAL Therapy MUST be considered with significant shortages. Evaluate antibiotic usage for appropriateness (Procalcitonin levels, MRSA swabs).
NEW June 2018: Local Anesthetics (e.g. Lidocaine)
NEW June 2018: Calcium Gluconate in Adult TPNs is no longer available as of June 29th
Loop Diuretics (specifically Bumetanide injection as of 12/2017)
IV Potassium Memo on Shortage with Recommendations [Puerto Rico impact]
- For all patients that can tolerate oral/enteral administration, use oral potassium
- Potassium Small Volume Parenteral Shortage Memo
IV Metronidazole Shortage Alternative Information [Puerto Rico impact]
- Restrict usage to severe-complicated Clostridium difficile infections (combined with orally-administered vancomycin)
- IV Metronidazole Shortage Information with Alternative Guidance
IV Heparin Memo on Shortage (Pharmacy will be using 1/2 Normal Saline Product) [Puerto Rico impact]
Internet Resources
- ASHP Medication Shortage Information
- ASHP Guidance on SVP Shortage
- FDA Medication Shortage Information
UConn Health Pharmacy Guidance for Past Shortages