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McKesson 12/13/11 Rx Availability Update

INJECTABLE FENTANYL STATUS

Situation: All manufactures are on backorder. 1) Hospira production delays due plant
issues/upgrades; 2) Westward acquired Baxter’s Fentanyl products, delaying
production.
Below are the items, listed by Supplier, that are expected to be the 1st to recover.
Check these for availability frequently:
Hospira items expected to begin shipping in mid-late Dec:
416255- FENTANYL CITRATE, CJECT 0.05MG/ML 2ML (10/PK)
337307- FENTANYL CITRATE, AMP 0.05MG/ML 5ML (10/PK)
Westward Items expected to begin shipping in mid-late Dec:
402673- FENTANYL CITRATE, AMP 0.05MG/ML 5ML (10/BX)
402677- FENTANYL CITRATE, SDV 0.05MG/M 50ML CII
732779- FENTANYL, VL 50MCG/ML 5ML (25/CT) CII

No single drug can be substituted for Fentanyl. The choice of an alternative drug must
be patient-specific, based on the clinical situation & based on physician discretion.
The below items are currently available and may be considered as a alternative to
Fentanyl during this time:

562689- MEPERIDINE HCL, VL 100MG/ML (25/CT) CII
690246- MEPERIDINE PCA, CART 10MG/ML 30ML (10/CT) CII
464534- MORPHINE, CJECT LL 15MG/ML 1ML (10/BX) CII
402823- MORPHINE, SDV 15MG/ML 1ML (25/PK) CII

420409- MORPHINE, FTV 50MG/ML 50ML CII
460802- DEMEROL, CJECT 25MG/ML 1ML (10/PK) CII
454996-
DEMEROL, CJECT LL 75MG/ML 1ML (10/PK) CII
452733-
DEMEROL, CJECT 100MG/ML 1ML (10/BX) CII
631820- DEMEROL, AMP 100MG/ML 1ML (25/BX) CII
352723- DEMEROL, AMP 75MG/ML 1.5ML CII
333308- DEMEROL, MDV 100MG/ML 20ML CII
453352- DEMEROL, CJECT 50MG/ML 1ML (10/PK) CII
333312- DEMEROL, AMP 25MG/0.5ML 0.5ML (25/BX) CII

• Suppliers wil begin fil ing these backorders on a FIRST IN FIRST OUT BASIS. Once product is received, it goes out very quickly.   Where to find more information:
For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=647
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=664

Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679).
MIDAZOLAM STATUS

Situation: Manufactures are beginning to come off of backorder. 1) Wockhardt & Cura
withdrew from the market; 2) Hospira production delays due plant issues/upgrades; 3)
Bedford suspended manufacturing due to required maintenance; 4) Remaining
suppliers are unable to keep up with the increased demand.
Recovery is expected on most presentations of Midazolam by Feb 2012.
Hospira items currently shipping intermittently:
763433- MIDAZOLAM ISEC, PFS 1MG/ML 2ML UD (10/CT) CIV
Hospira items expected to begin shipping in late Dec:
515043- MIDAZOLAM HCL, FTV 5MG/ML 1ML (10/PK 5PK/CS) CIV
460148- MIDAZOLAM HCL, VL 1MG/ML 10ML (10/BX) CIV
448926- MIDAZOLAM HCL, FTV 5MG/ML 10ML (10/BX) CIV
APP items expected to begin shipping in late Dec:
726577- MIDAZOLAM, MDV 1MG/ML 5ML (25/CT) CIV
736550- MIDAZOLAM HCL, MDV 5MG/ML 5ML (10/CT) CIV
736551- MIDAZOLAM HCL, MDV 5MG/ML 10ML (10/CT) CIV
Westward items expected to begin shipping in late Dec:
701428- MIDAZOLAM, VL DIST 1MG/ML 2ML (10/PK) CIV
701427- MIDAZOLAM, VL DIST 1MG/ML 2ML (25/PK) CIV
406640- MIDAZOLAM HCL, VL 5MG/ML 1ML (10/BX) CIV

Suppliers wil begin fil ing these backorders on a FIRST IN FIRST OUT BASIS. Once product is received, it goes out very quickly. Where to find more information:
For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=858
Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679).
LIDO/BUPIVA/XYLO/MAR “CAINE” DRUGS STATUS

Lido/ Bupiva /Xylo/Mar “CAINE” Drugs:
Most presentations are on intermittent back order and is being released as it becomes available. Supply should improve by 2012. Hospira is releasing product on a FIRST IN FIRST OUT BASIS. Once product is received, it goes out very quickly. Listed below are the items with the best availability. Check Supply Manager for
information on additional items
.

LIDOCAINE items that are CURRENTLY available :
243242- LIDOCAINE HCL, SDV 0.5% 50ML (25/PK 2PK/CS)
747154- LIDOCAINE HCL +EPI, FTV 1% 30ML (25/BX)
243240- LIDOCAINE HCL, MDV 0.5% 50ML (25/PK 2PK/CS)
243244- LIDOCAINE HCL, AMP 4% 5ML (25/PK)

BUPIVACAINE items that are CURRENTLY available :
336183- BUPIVACAINE, VL PF 0.75% 10ML (25/PK 2PK/CS)
242454- BUPIVACAINE, FTV 0.25% 50ML (25/PK 2PK/CS)
764304- BUPIVACAINE +EPI, VL 0.25% 30ML (25/BX)

XYLOCAINE very limited availability, check supply mgr for specific items.
MARCAINE items that are CURRENTLY available :
228221- MARCAINE HCL, SDV PF 0.75% 10ML (10/BX)
57202- MARCAINE HCL +EPI, VL 0.25% 50ML
57199- MARCAINE HCL, VL 0.25% 50ML

Where to find more information:

For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=828
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=675
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=723
Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679). LABETALOL INJECTION STATUS

Labetalol Injection
Every manufacturer of Injectable Labetalol is experiencing backorders & intermittent
shipments. Hospira has manufacturing delays; Bedford Labs, Akorn and Sagent have
similar offerings in their catalog, but are unable to supply the market due to the
overwhelming demand that shifted from Hospira.
Full recovery is not anticipated until Jan 2012. Where to find more information:
For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=397
Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679).
BEDFORD LABS SUSPENDS MANUFACTURING (AFFECTED DRUGS)

Glucagen & Other Bedford Labs Products
Bedford Labs made the voluntary decision to temporarily suspend the manufacturing, release and shipment of all products to perform past-due preventative maintenance work. (See attached letter to customers). Key Products Affected:
480553- GLUCAGEN DIAG KIT, VL 1MG
462511- GLUCAGEN, VL 1MG (10/CT)
668349- ADENOSIN, VL 3MG/ML 2ML (10/CT)
429183- BUTORPHAN SDV 2MG/ML BEDF 10
351844- KETAMIN VL 500MG 10ML BEDF 10

Where to find more information:
http://www.bedfordlabs.com/news/news/news_archive/2011/enter_date.html Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679). KETOROLAC STATUS

Ketorolac
Ketorolac supply is improving. Full recovery is expected in Dec 2011. The Ketorolac items below have the best availability:
333340- KETOROLAC TROMETHAMINE, FTV 30MG/ML 1ML
769788- KETOROLAC, VL 30/ML 1ML (25/CT)
722214- KETOROLAC, VL 30/ML 1ML (10/CT)
787210- KETOROLAC, VL 15/ML 1ML (10/CT)



Where to find more information:
For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=593
Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679). DIAZEPAM INJECTION STATUS

Diazepam Injection
Hospira is the only manufacturer of Injectable Diazepam. Hospira has manufacturing
delays due to raw material shortages. Currently there are only TAB presentations
available of this drug.
Full recovery is not anticipated until March 2012. Products Affected:
443619- DIAZEPAM, CJECT 5MG/ML 2ML (10/PK) CIV.  
636203- DIAZEPAM, FTV 5MG/ML 10ML (10/PK) CIV

Where to find more information:
For more information, see the American Society of Health Systems Pharmacists web site:
http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=492
Contact your McKesson Sale Rep with questions. Questions? Contact McKesson at 866.McK.ANSWer (866.625.2679).

Source: http://industryrxsupply.mckesson.com/communications/12.13.11_rx_communication_rev2.pdf

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Travel-Acquired Leptospirosis Androula Pavli , MD, FRACGP * and Helena C. Maltezou , MD, PhD † * Offi ce for Travel Medicine and † Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece International travel is rapidly growing worldwide. Microbiology It has been estimated that international travels Leptospi

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