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01/31/2017 DC -- Labetalol Shortage

From: "David Collette”

To: Pharmacists

Sent: Tuesday, January 31, 2017 3:44:12 PM

Subject: labetalol shortage/impending outage

We have been informed that there is an IV labetalol shortage that could threaten our ability to supply it for treatment of acute hypertension. Keith is doing everything he can to get more, and we just got word that 2,000 labetalol syringes will arrive Friday; however, the possibility of a shortage still looms.

There are several choices for acutely lowering b/p. Hydralazine and enalaprilat IV are very cost effective choices, but obviously won't work for all patients. Other options include clevidipine, nicardipine, and nitroprusside (all VERY expensive and with their own issues). If PO is an option, labetalol, clonidine, and captopril are possibilities.

For patients who can tolerate the reflex tachycardia, please consider the viability of hydralazine - it can be used in pregnancy and is already listed an a PRN option along with labetalol. We have a plentiful supply of the alternative products and Keith is going to monitor this situation closely and will inform me of any change in supply.

Please continue to use labetalol IV as judiciously as possible and consider IV hydralazine (or PO drugs!) when possible to preserve our supply of labetalol IV as long as possible.

DAVID

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David R. Collette, Pharm.D., FASHP

Operations Manager, Professional Services Huntsville Hospital Department of Pharmacy