Papworth Hospital, Cambridge
EditorSince mid-2000, a shortage of raw materials has had a considerable impact on the availability of isoproterenol hydrochloride in the UK and USA. While the US shortage appears to have been resolved in August 2001,1 commercial supplies of isoproterenol hydrochloride are no longer available in the UK. In May 2002, after exhaustive attempts to locate an alternate source of raw materials of sufficient quality, Forest Laboratories UK Ltd (Pharmax Ltd, Bexley, Kent) reluctantly announced the discontinuation of isoproterenol hydrochloride (Saventrine IVTM).2 Celltech Medeva (Leatherhead, Surrey), the only other UK supplier of isoproterenol products, discontinued supplies of Min-I-Jet® Isoprenaline in 2001.
While other treatments for symptomatic bradycardia and refractory torsade de pointes do exist, the loss of isoproterenol hydrochloride could potentially pose a serious problem for those involved in cardiothoracic transplantation and cardiac electrophysiology. Fortunately, the sulphate salt of isoproterenol is available from a number of special manufacturers including the Pharmaceutical Manufacturing Unit attached to Torbay Hospital. Isoproterenol sulphate is less potent than the hydrochloride salt and is currently unlicensed in the UK.3 Isoproterenol sulphate 0.1125% (2.25 mg/2 ml, equivalent to 2 mg/2 ml isoprenaline HCl) should now be available to hospital pharmacies.3
J. E. Arrowsmith
Cambridge
UK
References
1 US Food and Drug Administration, Center for Drug Evaluation and Research web site (http://www.fda.gov/cder/drug/shortages/)
2 Personal communication: Caroline Bolton, Medical Information Department, Forest Laboratories UK Ltd, Bexley, Kent DA5 1NX, UK
3 Personal communication: Phil Bendell, NHS Pharmaceutical Manufacturing Unit, Torbay Hospital, UK