Comprehensive Pharmacy Services Takes Immediate Action to Mitigate National Nitroglycerin Shortage

Second Significant Drug Shortage in Under Six Months as IV Saline Shortage Continues


MEMPHIS, Tenn., April 2, 2014 (GLOBE NEWSWIRE) -- Comprehensive Pharmacy Services (CPS), the nation's largest pharmacy services provider, with 400 hospitals and health systems clients throughout the country, has immediately taken steps to ensure patient safety and quality of care in response to the recently announced national shortage of intravenous (IV) nitroglycerin. The IV nitroglycerin shortage follows on the heels of the ongoing IV saline shortage, and is the second shortage of a hospital and emergency room drug staple in less than six months.

"In the 40 years we've been in the pharmacy services business we've never seen a time when two critical drugs have been in such short supply, let alone virtually unavailable, as is the case with nitroglycerin," said Marvin Finnefrock, Pharm. D., Divisional Vice President for Clinical Services. "Unlike with the IV saline shortage, for some conditions there are no alternatives or substitutes for IV nitroglycerin, so managing through this crisis requires a much different response and action plan."

Dr. Finnefrock explained that the IV nitroglycerin shortage is of serious concern because it is one of the most commonly used drugs in hospital emergency rooms, and is often used as first line treatment. On average, a mid-sized hospital will use approximately 2,000 doses of IV nitroglycerin annually.

"With two of three U.S. manufacturers unable to supply nitroglycerin, the sole manufacturer has resorted to rationing – delivering just 20% of historical orders, in order to provide healthcare facilities with limited supplies of the drug," Dr. Finnefrock added. "While steps are being taken to ease the shortage, such as seeking overseas sources and manufacturer ramp-ups of domestic production, as we've seen with the IV saline shortage, hospitals need to be prepared for a protracted nitroglycerin shortage."

CPS is advising that medical, nursing and pharmacy staff work together on a three-part approach to manage through the nitroglycerin shortage:

  1. Inventory Control: Immediately conduct a usage review in all areas where IV nitroglycerin is routinely used. Set up basic guidelines leading to conservation of a limited resource. For 24-hour pharmacies, relocate supply and dispense from the main pharmacy.
  2. Substitution: There is no direct substitution. Alternative routes can include topical, under the tongue and oral use where clinically indicated.   
  3. Communication: Implement a timely communication plan to all clinical staff involved in ordering or administering IV nitroglycerin, keeping them informed of the status of the shortage and supplies available to the facility. The goal of the communication is to engage staff in inventory efforts and keep them informed of actions planned by clinical leadership to mitigate shortage challenges.

About Comprehensive Pharmacy Services:

Employing over 1,800 pharmacy professionals, CPS is the nation's largest provider of pharmacy services to more than 400 hospitals and healthcare facilities leading to sustainable improved quality and reduced cost. CPS services include pharmacy consulting, inpatient and outpatient pharmacy management, telepharmacy and transition of care services. For more information, visit www.cpspharm.com.


            

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