This week we are once again providing an update on the most recent drug shortages.

Drug shortages currently remain at over 100 different medications, with the Food and Drug Administration (FDA) noting 120 products as being unavailable. Some of these shortages are short term, or limited availability, while others are completely unavailable with unknown release dates.

As noted above, the current list stands at 120 products, which is up four from our last update in February. Below we have two separate lists of medications in short supply. The first list covers the most commonly used medications in ambulatory surgery centers, while the second addresses medications commonly used long-term care facilities.

Common ASC medications in short supply:

Acetazolamide Injection
Atropine Sulfate Injection
Azithromycin (Azasite) Ophthalmic Solution 1%
Bacteriostatic 0.9% Sodium Chloride Injection
Bacteriostatic Water for Injection
Bupivacaine Hydrochloride and Epinephrine Injection
Bupivacaine Hydrochloride Injection
Calcium Gluconate Injection
Cefazolin Injection
Cefotaxime Sodium Injection
Chloroprocaine Hydrochloride Injection
Cyclopentolate Ophthalmic Solution
Dexamethasone Sodium Phosphate Injection
Dexmedetomidine Injection
Dextrose 10% Injection
Dextrose 25% Injection
Dextrose 5% Injection
Dextrose 50% Injection
Digoxin Injection
Diltiazem Hydrochloride Injection
Dobutamine Hydrochloride Injection
Dopamine Hydrochloride Injection
Epinephrine Injection, 0.1 mg/mL
Epinephrine Injection, Auto-Injector
Fentanyl Citrate (Sublimaze) Injection
Furosemide Injection
Gentamicin Sulfate Injection
Heparin Sodium and Sodium Chloride 0.9% Injection
Hydrocortisone Tablets
Hydromorphone Hydrochloride Injection
Hydroxypropyl (Lacrisert) Cellulose Ophthalmic Insert
Ketamine Injection
Ketorolac Tromethamine Injection
Lidocaine Hydrochloride (Xylocaine) Injection
Lidocaine Hydrochloride (Xylocaine) Injection with Epinephrine
Lipid Injection
Lorazepam Injection
Mannitol Injection
Mepivacaine Hydrochloride Injection
Methylprednisolone Acetate Injection
Midazolam Injection
Morphine Sulfate Injection
Ondansetron Hydrochloride Injection
Physostigmine Salicylate Injection
Potassium Acetate Injection
Potassium Chloride Concentrate Injection
Promethazine (Phenergan) Injection
Propofol Injectable Emulsion
Protamine Sulfate Injection
Ropivacaine Hydrochloride Injection
Sodium Acetate Injection
Sodium Bicarbonate Injection
Sodium Chloride 0.9% Injection Bags
Sodium Chloride 23.4% Injection
Sodium Chloride Injection USP, 0.9% Vials and Syringes
Sodium Phosphates Injection
Sterile Water for Injection
Triamcinolone Acetonide Injectable Suspension
Triamcinolone Hexacetonide Injectable suspension
Valproate Sodium Injection
Vecuronium Bromide for Injection

Common LTC medications in short supply:

Amino Acids
Amoxapine Tablets
Amphetamine Aspartate; Amphetamine Sulfate; Dextroamphetamine Saccharate; Dextroamphetamine Sulfate Tablets
Amphetamine Oral Suspension, Extended Release
Azithromycin (Azasite) Ophthalmic Solution 1%
Bacteriostatic 0.9% Sodium Chloride Injection
Bacteriostatic Water for Injection
Belatacept (Nulojix) Lyophilized Powder for Injection
Bupivacaine Hydrochloride and Epinephrine Injection
Bupivacaine Hydrochloride Injection
Calcium Gluconate Injection
Cefazolin Injection
Cefixime Oral Capsules
Cefotaxime Sodium Injection
Cefotetan Disodium Injection
Chlordiazepoxide Hydrochloride Capsules
Cortisone Acetate Tablets
Cyclopentolate Ophthalmic Solution
Cysteamine Hydrochloride Ophthalmic Solution
Desmopressin Acetate Nasal Spray
Dexamethasone Sodium Phosphate Injection
Dextrose 10% Injection
Dextrose 25% Injection
Dextrose 5% Injection
Dextrose 50% Injection
Diflunisal Tablets
Digoxin Injection
Diltiazem Hydrochloride Injection
Disopyramide Phosphate (Norpace) Capsules
Dobutamine Hydrochloride Injection
Dopamine Hydrochloride Injection
Echothiophate Iodide (Phospholine Iodide) Ophthalmic Solution
Epinephrine Injection, Auto-Injector
Fluvoxamine ER Capsules
Gemifloxacin Mesylate (Factive) Tablets
Gentamicin Sulfate Injection
Guanfacine Hydrochloride Tablets
Heparin Sodium and Sodium Chloride 0.9% Injection
Hydrocortisone Tablets
Hydroxypropyl (Lacrisert) Cellulose Ophthalmic Insert
Imipenem and Cilastatin for Injection
Isoniazid Injection
Ketoprofen Capsules
Leuprolide Acetate Injection
Lidocaine Hydrochloride (Xylocaine) Injection
Lorazepam Injection
Mannitol Injection
Methyldopa Tablets
Methylprednisolone Acetate Injection
Morphine Sulfate Injection
Nefazodone Hydrochloride Tablets
Nizatidine Capsules
Ondansetron Hydrochloride Injection
Pantoprazole Sodium for Injection
Rifampin Capsules
Rifapentine Tablets
Sodium Chloride 0.9% Injection Bags
Sodium Chloride Injection USP, 0.9% Vials and Syringes
Sterile Water for Injection
Sulfasalazine Tablets
Tacrolimus Capsules
Thiothixene Capsules
Tocilizumab Injection
Trimethobenzamide Hydrochloride Capsules
Varenicline Tartrate (Chantix) Tablets

Steps you can take:

The solution to each shortage is going to differ by the medication involved and the available alternatives. In a previous post titled “Ten Steps to Dealing with Drug Shortages”, I discussed ways to deal with shortages.

If you are currently struggling with a particular shortage, work with your pharmacy consultant to come up with creative ways to work around it. This requires planning and expertise. Some solutions may seem obvious and easy, but they could be dangerous to patient safety and often not compliant with licensing or accreditation standards. If you have questions about a current shortage, or how to set up a compliant system, don’t hesitate to reach out to us.

The Consultant Pharmacists at OctariusRx provide guidance on safe medication management, survey readiness and cost savings to ambulatory healthcare facilities/surgery centers, senior care facilities and pharmacies. We also help individual patients optimize their medications to improve their quality of life and save money. Contact us for assistance.