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06/26/18 DC -- Hydralazine IV

From: David Collette

Cc: Keith Moss

Sent: Tuesday, June 26, 2018 1:14:42 PM

Subject: Hydralazine IV

We are currently unable to obtain IV hydralazine and the product is "zeroed out" at our wholesaler. Here is what we need our pharmacists to work on in non-L&D adult patients now:

    * Review profiles now and daily for hydralazine IV orders.

    * Automatically discontinue orders for hydralazine IV in patients who have another option (commonly labetolol) for acute hypertension control

    * Work with the prescriber to choose an alternate drug for these patients (again, generally, this will be labetolol) for acute control of hypertension. Some IV options (after labetolol) include clevidipine, nicardipine, and nitroprusside (all with their own issues, including $$$). If the patient can take PO, labetalol, clonidine, nifedipine, and captopril are options.

    * This was presented at P&T today and they know that we will be pursuing these steps

    * Our current supply of hydralazine will be primarily reserved for L&D patients since they have few options for b/p control, especially if labetalol does not control it.

Thanks for you immediate attention to this pressing shortage.

DAVID

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David R. Collette, Pharm.D., FASHP

Operations Manager, Professional Services