Fentanyl shortage

[proman]

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Just got word of a looming fentanyl shortage. Anyone have the same issue?

 

[btbam]

Yes our hospital is out of 2cc and 20cc vials of fent.

 

[psychbender]

We've been out of 5mL and 2mL vials at my current outside facility for about two weeks now. The pharmacy has been splitting 20s under the sterile hood.

 

[pgg]

Both places I work say they have enough to last until the next expected delivery.

 

[Frank Rizzo]

We've been out of 5mL and 2mL vials at my current outside facility for about two weeks now. The pharmacy has been splitting 20s under the sterile hood.

same here

 

[TrustMe]

Have been told we have a 3-4 week supply.

 

[Idiopathic]

craziness. i just heard about this today, they expect us to be out by next week

 

[proman]

I tried alfentanil just because it was available and I had never used it. Disappointed so far. I gave 500 mcg bolus prior to intubation. Pt was pulling 1.7L tidal volumes but still reacted to intubation. Maybe it's better as an infusion but I'll probably use sufentanil for bolusing in the future. I predict many reintubations in the PACU.

 

[btbam]

I've seen 6-700 mcgs of alfentanil used just to sedate a pt for a retrobulbar, so you might need more for laryngoscopy.

 

[Arch Guillotti]

I tried alfentanil just because it was available and I had never used it. Disappointed so far. I gave 500 mcg bolus prior to intubation. Pt was pulling 1.7L tidal volumes but still reacted to intubation. Maybe it's better as an infusion but I'll probably use sufentanil for bolusing in the future. I predict many reintubations in the PACU.

Try 1000 mcgs and give it a couple of minutes to work.

 

[DrN2O]

Try 1000 mcgs and give it a couple of minutes to work.

I give 200-500mcg for the retrobulbar blocks and they don't go apnic. It hits them about 90 seconds or so. But I don't think it's a good replacement for fentanyl in most situations

 

[rsgillmd]

We've been out of the 5 ml vials for at least 2 weeks now. The pharmacist I asked couldn't give me an explanation.

We still have 2 ml vials.

I haven't used a 20 ml vial since residency.

Nothing listed on FDA page about yet about Fentanyl shortage.

 

[Dipipanone]

http://www.ashp.org/DrugShortages/Current/bulletin.aspx?id=647

Fentanyl Injection

[20 October 2011]
Products Affected - Description


Fentanyl Injection 50 mcg/mL, Hospira
10 mL ampules (NDC 00409-9093-36) - discontinued
2 mL Carpuject syringe (NDC 00409-1276-32)
2 mL ampule (NDC 00409-9093-32)
20 mL ampule (NDC 00409-9093-38)
2 mL vial (NDC 00409-9094-22)
5 mL vial (NDC 00409-9094-25)
20 mL vial (NDC 00409-9094-31)
50 mL vial (NDC 00409-9094-61)

Fentanyl Injection 50 mcg/mL, West-Ward (formerly Baxter products)
10 mL ampule (NDC 10019-0034-73) - discontinued
30 mL single-dose vial (NDC 10019-0036-82) - discontinued
2 mL ampule (NDC 10019-0038-67)
5 mL ampule (NDC 10019-0033-72)
20 mL ampule (NDC 10019-0035-74)
2 mL vial (NDC 10019-0037-27)
5 mL vial (NDC 10019-0037-30)
20 mL vial (NDC 10019-0037-25)
50 mL vial (NDC 10019-0037-83)


Reason for the Shortage

• West-Ward acquired Baxter’s fentanyl injection products in May, 2011. The company cannot provide a reason for the shortage.
• Hospira states the shortage is due to increased demand.

Estimated Resupply Dates

• Hospira has available fentanyl 50 mcg/mL 5 mL ampules (NDC 00409-9093-35) and 10 mL vials (NDC 00409-9094-28). The 2 mL Carpuject syringes are on intermittent back order and the company is releasing product as it becomes available. All other presentations are on back order with an estimated release date of mid-December, 2011 for the 20 mL and 50 mL vials, late-December 2011 for the 20 mL ampules, mid-January, 2012 for the 2 mL and 5 mL vials, and April, 2012, for the 2 mL ampules.
• West-Ward has all fentanyl 50 mcg/mL presentations on back order and the company estimates a release date of late-October, 2011 for the 5 mL vials, early-November, 2011 for the 5 mL ampules, 20 mL ampules, 20 mL vials, and 50 mL vials, and mid-November, 2011 for the 2 mL ampules.

 

[sevoflurane]

Out of the 2ml vials.

 

[periopdoc]

Out of 2's. Low on 5's.

Using Sufenta.

Happy with it.

Just remember to dilute it.

- pod

 

[btbam]

We've been out of the 5 ml vials for at least 2 weeks now. The pharmacist I asked couldn't give me an explanation.

We still have 2 ml vials.

I haven't used a 20 ml vial since residency.

Nothing listed on FDA page about yet about Fentanyl shortage.

No spines?

 

[W222]

Now one question I have is, how in the F@CK could a country like the US be short on fentanyl when this drug is made by junkies in labs throughout the world? WTF?

These drug companies should be dragged over the coals for the bull**** shortages they are creating to boost costs.

 

[rsgillmd]

No spines?

I've mainly used sufenta or remi for these.

The vast majority of the time I used the 20 ml fentanyl vials during residency was in cardiac. A couple of times in long spines, one peds crani, and a couple of narcotic tolerant patients also.

I'm in L&D today. We are out of the 2 ml and 5 ml vials. Pharmacy is preparing 2 ml and 5 ml syringes for us and placing them in the Omnicell.

 

[pgg]

Now one question I have is, how in the F@CK could a country like the US be short on fentanyl when this drug is made by junkies in labs throughout the world? WTF?

I'm no RV chemist, but I think you've been watching too much Breaking Bad. 🙂

These drug companies should be dragged over the coals for the bull**** shortages they are creating to boost costs.

Somehow I don't see Baxter or Hospira reaping windfall profits off 2 mL vials that retail for 42 cents and probably cost hospitals a lot less than that.

 

[W222]

I'm no RV chemist, but I think you've been watching too much Breaking Bad. 🙂QUOTE]

Actually, if you look into it, its not hard to make. If a member of the taliban can make herion in a hut in Afghanistan, fentanyl isn't a real stretch.

http://www.fox43.com/news/wpmt-rare-drug-lab-uncovered-in-dauphin-county,0,205171.story

Somehow I don't see Baxter or Hospira reaping windfall profits off 2 mL vials that retail for 42 cents and probably cost hospitals a lot less than that.

The issues isn't that fentanly is their money maker, but that they make profit off of other drugs that will be used in its place (ie. sufenta, remi, alfenta).

 

[DreamLover]

No spines?

I usually use sufenta for spines as well...remi for crani's and only recently have tried alfentanyl for a few smaller cases...I never used alfent one time during my residency