IV Nausea Medication Shortage Strikes Hospitals? No Compazine, Reglan Or Zofran!

I learned today that there is a nationwide shoratage of three of the top (and generic) medications used to treat nausea in this country.  IV Compazine (prochlorperazine) has been on the unobtainable list for months and months.  I recently learned that IV Reglan (metoclopramide) and now IV Zofran (ondansetrone) have joined to the ranks of the nearly impossible to obtain intravenous nausea medications in the hospital.  We've read alot in the last year about nationwide drug shortages.  It's not just rare and expensive drugs.  It's these generics that have been around for decades.

What's left?  We can give IV Phenergan (promethazine), which is plentifully available.  Unfortunately, due to a lawsuit in the not so recent past, it can now only be given with central venous access to prevent  doctors and hospitals from getting sued out of existence.  That pretty much made this medication unavailable to the masses of nauseated patients all across this country.  What's left? You can give some of them IM (intra-muscular) or you can give them orally, which is often difficult in patients who are throwing up or have nothing by mouth status after their surgery.

Add to that the nationwide shortage of intravenous Ativan and Versed and one has to wonder how hospitals can even stay open when such vital medications, standard of care in many circumstances, aren't available to treat patients.  If you are in the medical profession, and you have a smart phone, you can download a free app that will give you a list of current drug shortages, resolved shortages and unavailable drugs reported by the American Society of Health-System Pharmacists (AHSP) and the Food and Drug Administration (FDA).  This ingenious app even has an RSS feed to daily updates,

RxShortages-App-iPhone-ScreenshotRxShortages-iPhone-App-Screenshot

Search for this free app with the search term "rxshortages" and you'll find it. I've never seen so many drug shortages in my nearly ten years of hospitalist medicine.  It is concerning to say the least.   I'm sure the reasons are complicated, but probably involve a combination of drug company consolidation and government regulations.  The patient's don't care why.  I think, unfortunately, it's only going to get worse as ObamaCare works hard to take the profit out of medicine. 

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