What to do with Bupivacaine and lidocaine on backorder?

[Cholula]

How are you all dealing with the limited supply of bupivacaine and lidocaine? Some suppliers say that some will be in stock as early as September or may continue to be on backorder till 2019. I just ordered some mepivacaine and ropivacaine PF SDV because that is all I can order now.

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[swamprat]

Hasn't fully hit us yet but we are going to be using mepivicaine

 

[geauxg8rs]

Hasn't fully hit us yet but we are going to be using mepivicaine

I was just about to post same
Question

 

[Doctodd]

no need for Bupivacaine for years. Lidocaine finally back in stock and we used lidocaine vials and ropiv while we waited. Check different concentrations of lidocaine and just dilute with PFNS.

 

[BobBarker]

I have a lot of both and haven’t heard of any issues.

 

[pastafan]

No lidocaine at Henry schein. Where is it in stock?

 

[oreosandsake]

clint pharmaceuticals

Ask for April

 

[Aether2000]

Lidocaine has been on a nationwide shortage for a couple of months now and even Clint has had only limited supplies. The lidocaine shortage will partially be eased by some manufacturers picking up production in June and July 2018. Bup and Rop are also on nationwide shortage. Manufacturers have found it is more profitable to make other drugs and have not made the shortage drugs in their plants. Their claim is that there is an increased demand for most of the drug shortages, but this is likely to be nonsense and a smoke screen.

 

[lobelsteve]

Have not seen shortage of anything but 025% bup with epi. But that was in yesterday when I was doing cases at hospital.

 

[Ducttape]

Lido shortage is pretty ubiquitous.

Ended up using 2 ml bottles of 2% for RFA at ASC.

It strikes me a lot like the supposed gas shortages we have.

How are gasoline prices rising when there is a surplus in the US and crude is trading so low, I always wonder

 

[SSdoc33]

i havent been able to get 0.5% bupi. no problems with lido. its a hassle, but not the end of the world

 

[PapaDosh]

Lido shortage is pretty ubiquitous.

Ended up using 2 ml bottles of 2% for RFA at ASC.

It strikes me a lot like the supposed gas shortages we have.

How are gasoline prices rising when there is a surplus in the US and crude is trading so low, I always wonder

I thought the current lidocaine & NS (amongst other medications) shortages were at least partially secondary to production in Puerto Rico still be affected by the hurricane.

 

[Ducttape]

in case people doubt that there is a shortage, here is a website to check out (so its not Fake News):

FDA Drug Shortages

looks like most companies are saying the main reason is "demand increase for drug"

here is bupivacaine: FDA Drug Shortages

 

[gdub25]

We’ve been scrambling for lidocaine for a couple months. Have had to change our practice some to limit our usage. Nearly every place we order from has put limits on what we can order at one time, including Clint and Henry Schein

 

[deleted185747]

My joke about an extra charge for lidocaine won’t be funny when it’s true.


OTOH my wife gives complementary nitrous when she drills teeth...

 

[clubdeac]

I can't help but think this is due to the fact that we all have to throw out every bottle after accessing the bottle one time. I use 2-3cc's lidocaine for every 20cc bottle I throw away. On my busy days I probably waste about 280cc or the equivalent of 14 full bottles of lidocaine. It's absolutely ridiculous. The fact the hospital won't let me use a multidose vial like it's supposed to be used is absolutely insane

 

[Ducttape]

Why are you buying 20 mL bottles in the first place?

You can’t blame that waste on having to use single use bottles, not when - when available - you can buy 2 or 5 or 10 mL bottles...

 

[clubdeac]

Why are you buying 20 mL bottles in the first place?

You can’t blame that waste on having to use single use bottles, not when - when available - you can buy 2 or 5 or 10 mL bottles...

2 or 5ml bottles?!?! Are you kidding me... I've never seen a 2 or 5ml bottle of anything. The only meds that come in small quantities are the steroids that come in 1ml vials. Are you messin with me duct??

 

[Ducttape]

the hospital system uses 5 ml 1% glass ampules from Spectra, i believe.

the ASC used Auromedics 2% 2 ml bottle the last 2 weeks (instead of multidose bottle i usually use) and Hospira 1% 5 ml bottles.

i think the 0.25% bupiv 5 mL bottles were also Hospira.
as examples....

 

[lobelsteve]

no issues getting 1% lido 50ml bottles or 0.25% bupi 50ml bottles.