Epoprostenol (Flolan®, Veletri®) remains on national shortage, and we are currently unable to obtain a reliable supply through our wholesaler. At present, our inventory is limited to approximately eight remaining doses. According to information provided by the manufacturers, additional product may become available "sometime this summer;" however, no firm release date or allocation information has been provided. Unfortunately, treprostinil (Remodulin®), a commonly considered alternative prostacyclin therapy, is also unavailable due to supply constraints.

Potential therapeutic alternatives may include:

• Inhaled nitric oxide
• Sildenafil
• Other patient-specific pulmonary vasodilator strategies as clinically appropriate

Given the limited supply, Pharmacy recommends careful review of all new requests for epoprostenol therapy and consideration of alternative treatment options when feasible. Pharmacy will work closely with practitioners, Respiratory Therapy, and other affected services to evaluate alternative therapies as needed. We will continue to monitor the situation and provide updates as new information becomes available. If inventory reaches critically low levels or becomes depleted, additional guidance will be communicated promptly.

Please contact your pharmacist with any questions regarding patient-specific management or alternative therapy recommendations.

DAVID