Microsoft word - backorder update 10 03 13.doc

Backorder Update 10/03/2013

Acetylcysteine injection used as an oral solution or nebulizer solution - Currently the supply of 20%
30mL vials is ok. The 10%, all vial sizes, are still unavailable. We still have a small amount of the 10%
on shelf (12 of the 30ml vials on shelf in the pharmacy). Will continue to draw both 10% and 20% into
prefilled syringes. Nebulized orders for acetylcysteine are still limited to Pulmonologists and still expire
after 48 hours. The hospital is continuing to use acetylcysteine IV (ACETADOTE) for acetaminophen
overdoses.

Aminosyn-Currently Aminosyn 15% bags are on backorder through October 2013. Pharmacy has a
limited amount of the 15% and will use this for patients that require a concentrated TPN formula.

Atropine Injection-All extended dating bristojects have been pulled. We have been able to get some
bristojects to replace these. Currently we are still only stocking one bristoject per crash cart. We will
continue to monitor stock levels on Atropine bristojects for now.

Bupivicaine 0.25% and 0.5% with epi – on/off backorder – currently have mix of 10mL and 30mL
vials. We will continue to monitor for now.

Bupivicaine plain 0.25%, 0.5%, 0.75%—in short supply. We have a mix of 10ml and 30ml vials in
other strengths and are filling with what we have.

Calcium Chloride-All forms of Calcium Chloride injection are on backorder. Still waiting on the
vials to come off backorder. We still have a large stock of bristojects from our last bulk order. The vials
are back to not having a release date.

Calcium Gluconate-Back and forth availability, we are getting what we can when we can. Currently we
still have conservation measures in place and the supply we are getting should still cover our needs.
Dextrose 5%-The PVC-free bags are on backorder from Hospira and BBraun. We are currently
working to find a substitute for this product. We will either be going to another brand of bag if we can
find it or a glass container. We are currently working with hospitals who have extra stock to get us
through until we find a new product. These bags are required for drips like amiodarone and Ativan.

Droperidol (INAPSINE) injection-Injection will be on backorder through the end of the year. We are
keeping a sublingual version in stock for now for ER use.

Doxapram injection – Current Count =1 Backlash from Bedford’s market withdrawal. Westward plans
a release for October 2013. No more extra stock is available at this time.
Glycopyrrolate Injection- Currently on backorder with no release date. We have found a 0.4mg/2ml
prefilled syringe that we will be stocking in the OR machines. This will keep us from having to deal
with the confusion of the multi-dose vials. These syringes are allocated right now from Pharmedium.
We should be getting around 275 doses per month. If we do run out we will have some multi-dose vials
for backup.

Heparin Premixed bags-Hospira has Heparin premix drips on backorder. Pharmacy will be making and
sending up all Heparin drips 25,000 units/500mL on a patient specific basis.
Kinevac Injection-All supply has been exhausted. Bracco now has no release date for the product.
Pharmacy will continue to keep an eye out for any available stock. Radiology has a meal substitute plan
in place.

Lidocaine 2% 20mL vials – temporary switch to 10mL vials. Once we use up the 10ml vials we
currently have in stock we can go back to the 20ml vials.
Lipids-We are currently under allocation of 11 cases a month. For now we will be only giving lipids on
Monday and Thursdays. This should get us through the allocation period.

Magnesium Sulfate Inj.- We will be switching back and forth between Pharmedium and Hospira
product for the premade drips depending on what we can get. Pharmacy will make sure that all ICU
pods have stock available in Pyxis for use at all times.

Morphine 100 mg Advantage vials –The floors use the 100 mg ADD-Vantage vials to pop together
morphine 1:1 drips on the floor. Hospira is trying to release product by late October. In the meantime
Pharmacy will compound the 1:1 drips and stock in the PYXIS refrigerator as needed.

Nalbuphine 10mg/ml- Pharmacy is pulling up syringes from multi-dose vials and loading in the
refrigerators in pyxis. Hospira is planning on having some of the 1ml vials available October 2013.
Nicardipine Injection-The vials are on backorder with no release date. Pharmacy has ordered some of
the premixed bags to get us through the shortage. The bags are the same concentration as the drips we
currently make, but have a different volume and strength (20mg/200ml).
Oxytocin Inj-Currently the 1ml vials are on backorder with no release date. We were able to order some
10ml multi-dose vials which we will stock in Pyxis if we have to.
Rifampin-Rifampin is on backorder with no release date. We currently have 3 vials in stock but that is
all. Pfizer had some manufacturing problems and this has caused other manufacturers to have less
product available on the market than usual due to increase in demand.

Pancuronium injection – Current Count: 0– Possible release date of late October 2013.

Papaverine Inj-On backorder with no release date. American regent is the sole producer of the drug.
Heritage will be making us a supply of papaverine until the drug arrives—stocked in OR Core
Pitocin bags-Currently the Dextrose 5%-Lactated Ringers one liter bags are on backorder. We have
switched from D5LR 1000mL with 30 units of Pitocin to D5LR 500 mL with 15 units of Pitocin. RX is
sending 2-500mL bags. This will keep the bag at the same concentration, while using a smaller bag.

Potassium Phosphate- We are trying to get this item from Heritage when we can. Supply is spotty as of
now, based on a raw materials shortage. If we are out of Pot Phos then pharmacist will assist in
converting to Sodium Phosphate where applicable. Hospira is trying to release product by late October
2013.

Sodium Phosphate-We have received a few shipments and are keeping an eye on stock for now.
Expecting another shipment available in late October 2013.
Sufenta inj-Currently the sufenta 1ml injection is on backorder with no release date. Pharmacy will be
loading the 2ml amps into Pyxis machines as the 1ml amps run out.
T-dap Vaccine-Currently all forms of T-dap vaccine (boostrix and adacel) are on backorder with no
release date. We are currently filling the T-dap vaccines in the L&D areas only. Pharmacy has a
tetanus/diphtheria vaccine available for ER if needed. Sanofi will be allocating monthly amounts of
Adacel, we will continue to order these as they are needed.

Tuberculin Test-There is a national shortage on tuberculin test vials. We have 14 vials in the pharmacy
as of now. Currently there is no release date for the vials. We are currently reserving the vials we have in
stock to use in the event of an exposure. Sanofi is allocating us a few vials of tubersol each month. We
are ordering this along with any other that we can find available.

Torsemide Injection-All of our Torsemide vials went out of date. Currently the vials are on backorder
with no release date.

Chemotherapy
Leucovorin – We have been able to get some 350mg vials. Stock availability is still low.
Doxorubicin – Back and forth availability. Usually only small amount available.
Epirubicin – There are small amounts available, but pharmacy needs early notice of doses to insure we
get drug here.
5-FU – APP is able to release small amounts of drug. Pharmacy still needs early notice whenever
possible to make sure drug is here.
Bedford Products: There are still some products that we are experiencing issues with from the
Bedford withdrawal. Currently affected medications are listed below.

Acyclovir injection
Chemotherapy Products
affected by Bedford

Source: https://physician-pdh.ascensionhealth.org/portal/binary/com.epicentric.contentmanagement.servlet.ContentDeliveryServlet/Backorder%2520Updates/backorder%2520update%252010%252003%252013.pdf