Shortages of Succinylcholine, Other Neuromuscular Blocking Agents Being Reported

It appears that once again, problems are arising with the supply and distribution of generic injectables nationally. According to ASA Vice-President for Scientific Affairs Bruce F. Cullen, M.D., there are fewer manufacturers producing the drugs, there is little profit motive and the manufacturing process is expensive and strictly regulated (compared to non-injectables). Thus, when there's a glitch in the supply pipeline, such as when one manufacturer ceases production, there is a significant spin-off effect felt by hospitals and ambulatory centers throughout the country.

Among the neuromuscular blocking agents reportedly in short supply are: atracurium, pancuronium, rapacuronium and succinylcholine. Also, cisatracurium and mivacurium were on nationwide back order due to manufacturing delays, but the products are now available from the manufacturer.

ASA is continuing to encourage the U.S. Food and Drug Administration (FDA), the American Medical Association, the American Hospital Association and the Pharmaceutical Research and Manufacturers of America to give serious consideration to resolving issues related to unanticipated and often unannounced drug shortages. ASA helped to initiate several earlier meetings with these principal agencies following a critical shortage of fentanyl just over three years ago.

For more information about the status of products affected, go to the Web site of the American Society of Health-System Pharmacists: http://www.ashp.org/shortage/nmba-combined.cfm

Drug shortages also are listed on the Web site of the FDA's Center for Drug Evaluation and Research at: http://www.fda.gov/cder/drug/shortages/default.htm