Lidocaine and Zofran shortages?

[coffeebythelake]

My hospital (large, academic center) has a critical shortage of lidocaine (in all formulations) and IV zofran. Anyone hear about this? Dealing w same problem? Is this a nation wide thing, or a vendor-hospital thing?

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[wholeheartedly]

My hospital (large, academic center) has a critical shortage of lidocaine (in all formulations) and IV zofran. Anyone hear about this? Dealing w same problem? Is this a nation wide thing, or a vendor-hospital thing?

small, rural critical access hospital in the midwest and we've been dealing with this as well.

 

[Gas]

Small community hosital - same for zofran, but lidocaine supplies adequate for now. We are also just starting to get hyperbaric bupivacaine spinal kits back.

 

[B-Bone]

Over the past several years, our hospital has had crazy shortages of every drug you can think of. What I have noticedm is that while these are always described by pharmacy as "nationwide shortages", in talking with friends in other parts of the country they know nothing of the shortage. We recently had a meeting of the anesthesia departments for our health system's 13 metro-area hospitals about "national" shortages that only seem to be affecting 1 or 2 hospitals in the same city. It's nuts.

 

[AdmiralChz]

We had a big lidocaine shortage in Texas back a few months ago. Thankfully no longer the case now.

Haven’t heard of any Zofran shortages - Droperidol for all!

 

[Psai]

Haldol or prochlorperazine instead of zofran

bupi instead of lido

 

[dchz]

Had both in Texas, but shortage is gone.

I stopped using lido for induction and haven't looked back.

when Zofran was short, i gave ondansetron instead

Promethazine 6.5 IV was the popular substitute, made me realize how sedating that drug is..

 

[nimbus]

Over the past several years, our hospital has had crazy shortages of every drug you can think of. What I have noticedm is that while these are always described by pharmacy as "nationwide shortages", in talking with friends in other parts of the country they know nothing of the shortage. We recently had a meeting of the anesthesia departments for our health system's 13 metro-area hospitals about "national" shortages that only seem to be affecting 1 or 2 hospitals in the same city. It's nuts.

I’ve had the same experience talking to friends who work at other places. Many drugs in short supply are still available at an inflated price through alternate suppliers. The decision is then left to the pharmacy manager.

 

[Aether2000]

634 bed hospital in Clearwater FL with critical shortage of lidocaine remi and several other drugs for the past 4 months

 

[pgg]

We had a big lidocaine shortage in Texas back a few months ago. Thankfully no longer the case now.

Haven’t heard of any Zofran shortages - Droperidol for all!

If I ever meet the jerk who got droperidol black box'd I'm going to kick him square in the nuts. Haven't seen it in any hospital for at least 6 or 7 years now.

Haldol is OK.

 

[oldguy55]

When we were told the IV preparation of ondansetron was in short supply, I started giving 8mg oral dissolving tablets in preop. Seems to work as well.

CRNAs or students who rotate through our community hospital tell us nobody else in the system has changed their practice and many haven't heard of a shortage.

 

[jwk]

When we were told the IV preparation of ondansetron was in short supply, I started giving 8mg oral dissolving tablets in preop. Seems to work as well.

CRNAs or students who rotate through our community hospital tell us nobody else in the system has changed their practice and many haven't heard of a shortage.

We did the same with the ODT. Worked fine.

 

[jwk]

Depending on the hospital/system, many facilities are part of multi-hospital buying consortiums. In theory, the buying power of hundreds of hospitals instead of one or just a few can bring down the price and help with availability. And I think truly large users tend to get some preference (# beds does not necessarily translate to big consumer). We are far from being one of the biggest hospitals systems in the country, but I know of several products we use where we are the largest consumer in the country of those particular items. But as we've seen with a lot of things (IV fluids as a prime example) limited manufacturing capability is also frequently to blame, with sometimes one plant serving a worldwide market.

 

[GlowInTheDark]

Small community hosital - same for zofran, but lidocaine supplies adequate for now. We are also just starting to get hyperbaric bupivacaine spinal kits back.

We just ran out of hyperbaric bupivicaine about 2 weeks ago.

 

[Psai]

When we were told the IV preparation of ondansetron was in short supply, I started giving 8mg oral dissolving tablets in preop. Seems to work as well.

CRNAs or students who rotate through our community hospital tell us nobody else in the system has changed their practice and many haven't heard of a shortage.

Iv zofran costs a few cents. Po costs a few dollars.

 

[Gas]

We are also using Zofran ODT for now. No word yet on when IV supplies returning.

I've also been using scopolamine patches and Emend for higher risk patients.

 

[sigrhoillusion]

Large academic level 1 trauma center on East coast and we jut went through the spinal bupi, zofran and lido shortages, just starting to get them back consistently. Now today I heard we're struggling to get ketamine in any concentration forms.

Ketmine... the oldest, cheapest drug on all the WHO pain med lists. I guess it's too cheap to profit off of for pharma...

 

[Psai]

Large academic level 1 trauma center on East coast and we jut went through the spinal bupi, zofran and lido shortages, just starting to get them back consistently. Now today I heard we're struggling to get ketamine in any concentration forms.

Ketmine... the oldest, cheapest drug on all the WHO pain med lists. I guess it's too cheap to profit off of for pharma...

They give out ketamine in these large 500 mg vials. I'm glad we have intelligent people making rules because theres nothing better than throwing away 95% of a really useful medication on shortage after using it on one patient.

 

[ProtonPump]

Iv zofran costs a few cents. Po costs a few dollars.

We are all very good at figuring out direct costs. What drives me crazy is that no one talks about indirect costs. If I can spend a few dollars and shorten a PACU stay or hospital admission which is being increased by PONV then I would.

 

[ProtonPump]

From what I can tell depending on how smart and resourced your hospital pharmacy manager is shortages affect you differently. If they are paying attention they identify coming shortages early and stockpile meds (exacerbating the shortage for everyone else) and they come up with an action plan to distribute the meds to the areas which have the highest needs. The places where they are not as organized send you an email which says "we have no more drug x"

 

[nimbus]

They give out ketamine in these large 500 mg vials. I'm glad we have intelligent people making rules because theres nothing better than throwing away 95% of a really useful medication on shortage after using it on one patient.

It’s packaged that way so you can give a large IM dose without injecting too much volume.

 

[nimbus]

From what I can tell depending on how smart and resourced your hospital pharmacy manager is shortages affect you differently. If they are paying attention they identify coming shortages early and stockpile meds (exacerbating the shortage for everyone else) and they come up with an action plan to distribute the meds to the areas which have the highest needs. The places where they are not as organized send you an email which says "we have no more drug x"

Agree.

We were never informed of a zofran shortage. We have been informed of a lidocaine shortage. However, our medication trays have been fully stocked with both items throughout. We haven’t had to adapt our use in any way except that we save the unused lidocaine vials that come in the line kits.

Where we have seen some supply interruptions are various concentrations of bupivacaine, but there’s always been an easy workaround.

 

[Pineapple_1010]

634 bed hospital in Clearwater FL with critical shortage of lidocaine remi and several other drugs for the past 4 months

I am dealing with SAME issue!!! Have you been able to get any in recently?? I heard of a company that helped one of my former colleagues out but i wasn't sure the deal with pricing and such?

 

[Mona nucleosis]

Northern NJ. Been short on lidocaine and bupivacaine for a few weeks now

 

[Noyac]

If I ever meet the jerk who got droperidol black box'd I'm going to kick him square in the nuts. Haven't seen it in any hospital for at least 6 or 7 years now.

Haldol is OK.

It was a lady from what I recall.

 

[Noyac]

When we were told the IV preparation of ondansetron was in short supply, I started giving 8mg oral dissolving tablets in preop. Seems to work as well.

I think there is another way of looking at this. If I were the pharmaceutical company I would bust my ass to get zofran out the door ASAP. I think there is real risk that we will find out that zofran isn’t as necessary as it once was for PONV. I know I give a lot less of it these days. I think our anesthestics are much better and therefore, less PONV as a result. For example, we are better with blocks, giving less narcotics and using TIVA more than in the past.

 

[kmurp]

Can’t get preservative free lidocaine for epidural use. No preservative free marcaine for spinal and mepivacaine running out.

 

[Noyac]

Time to close the doors.

 

[Pineapple_1010]

Northern NJ. Been short on lidocaine and bupivacaine for a few weeks now

This is short nationwide from what I have been hearing... Have you heard of when release date is?!?!

 

[DM27]

We haven't had a shortage issue with either but we have been having an opioid shortage recently, I guess that's the crisis I keep hearing about.