This notice is to inform you that erythromycin injection is currently on national backorder and is not expected to be available again until November–December 2025. Our in-house supply is very limited and projected to be exhausted within the next 10 days. Because erythromycin injection is commonly used at Huntsville Hospital for GI motility, we ask that you consider the following alternatives for your patients:

• Metoclopramide – Effective prokinetic agent; please be mindful of CNS side effects, including the risk of tardive dyskinesia with long-term use.

• Azithromycin injection – An off-label alternative for GI motility; note that it carries a warning for QT interval prolongation.

• Diet modification – Please consider non-pharmacological strategies where appropriate.

Important: We do have an adequate supply of oral erythromycin, but recognize this route may not be appropriate for some patients with severe dysmotility.

To preserve our remaining inventory, please reserve IV erythromycin for patients where no viable alternative exists.

We appreciate your cooperation in helping us manage this shortage. Please contact a pharmacist with any questions or to discuss patient-specific options.

David R. Collette, Pharm.D., FASHP, FALSHP
Operations Manager, Professional Services
Huntsville Hospital Department of Pharmacy
101 Sivley Road, Huntsville, AL 35801
Desk: (256) 265-6741; Cell: (256) 527-2560