3 Ways to Survive Drug Shortages in Clinical Practice

Given the many animal species and medical conditions veterinarians treat, it’s no wonder that drug availability is a top concern for practicing veterinarians. We understand the clinical challenges faced when therapeutics needed in clinical practice are suddenly short in supply. Reasons for shortages range from drug production process changes to sudden and unanticipated increases in demand for a drug. There are some ways you can get through drug shortage situations and still meet therapeutic needs of your patients:

Stay informed about a drug’s availability status.
You can learn more about current drug shortages, both veterinary and human, on the FDA website. The American Society of Health-System Pharmacists also maintains a list of human drugs that are in short supply. Through these websites, you will find reasons for the shortage, as well as relevant contact information to contact the manufacturer for the latest updates. Manufacturer websites also contain updates, like the most recent update on Adequan(R) availability.

Consider a different dosage or form.
For instance, doxycycline 100-mg capsules might not be available, but the 50-mg capsules might be. Or perhaps a different version of the drug is available (doxycycline monohydrate versus doxycycline hyclate, for instance). One helpful way to gain information on different dosage forms is through the American Academy of Veterinary Pharmacology and Therapeutics, which maintains USP Veterinary Clinical Drug Information Monographs that describe various therapeutic options. Remember to follow FDA’s Extra Label Drug Use Rules any time you are contemplating using a drug in a different way from what the label says. Also see AVMA’s extralabel drug use decision-making algorithm.

Consider an alternative medication.
Alternative therapeutics could be an option. For example, the USP Veterinary Clinical Drug Information Monographs and other formularies can be helpful, as can other specialty groups’ guidance documents. For example, the American College of Veterinary Internal Medicine’s Consensus Statement on Leptospirosis discusses antimicrobial treatment options, including antimicrobial alternatives to doxycycline when necessary.

You should know that if you are contemplating use of a compound as an alternative to treat your patient’s medical condition, both federal and state rules (see our state resources, and contact your state board of pharmacy) should be a part of your decision-making process. Also see our compounding webpage for more. The AVMA has no regulatory authority. We continue seeking legislative solutions for veterinarians’ ability to legally compound in medically necessary situations, particularly recognizing the critical needs in non-food animals.

Drug shortage concerns can be difficult in practice, but fortunately there are a number of resources that can help. Stay tuned for updates we become aware of, and remember that the NOAH Discussion Forum can be a great resource to chat about drug issues and other topics with fellow AVMA member colleagues.

3 thoughts on “3 Ways to Survive Drug Shortages in Clinical Practice

  1. For Dr. WINDLEY regarding the comments on July 29, 2013.

    In the interest of constructive commentary, let me suggest a re-write of your observations.

    “Dear Dr. Shim,
    This is certainly not a new problem and I have not seen this brought up for discussion in the past by the AVMA. Thank you for providing this information and opening up a dialogue with the AVMA membership in your blog.”

  2. Well, Dr. Shim, this is certainly not a new problem. However, it seems to be new on the AVMA Radar since they found that their membership was very unhappy!