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article imageHospitals in U.S. frantic over shortage of sodium bicarbonate

By Karen Graham     May 23, 2017 in Health
Most of us have a box of baking soda in the cupboard or refrigerator. It's plentiful on the grocer's shelves and cheap. But this "simple drug" is in short supply in hospitals across the country, prompting surgeries and other treatments to be rescheduled.
Baking soda is sodium bicarbonate, and in solution, it is used for all sorts of treatments and procedures in hospitals, clinics and doctor's offices, from chemotherapy treatments to correcting blood pH to easing the pain from stitches. It is also used as a poison antidote and in open-heart surgery.
Basically, you will definitely find sodium bicarbonate solution on any "crash cart" in a hospital. That is just how important this simple drug really is to medicine. However, it is in short supply, according to the New York Times, and indeed, surgeries and chemotherapy treatments have been either put on hold or reprioritized due to the shortage.
A box of baking soda
A box of baking soda
The U.S. has only two suppliers of sodium bicarbonate approved by the FDA for use as a medical drug, Pfizer, and Amphastar. Pfizer ran low because of a problem with one of its suppliers, and Arstechnica reports the issue was undisclosed due to "confidentiality agreements."
Because of Pfizer's shortages, customers searching frantically for the drug descended on Amphastar, quickly depleting their supplies. Both companies told the NYT they don't really know when supplies will be restored, speculating that it could happen no earlier than June or as late as August this year.
"Does the immediate need of a patient outweigh the expected need of a patient?" says the head pharmacist at a hospital in Mobile, Ala., commenting on the sodium bicarbonate shortage and calling it a "medical and ethical question that goes beyond anything I've had to experience before."
Cancer chemotherapy
Cancer chemotherapy
Phil and Pam Gradwell (CC BY 2.0)
Shortage sheds light on continuing shortage of inexpensive drugs
But most people don't realize that this has happened before with stocks of sodium bicarbonate and it's just another example of the shortages of inexpensive generic medicines we have in this country. There was a shortage of sodium bicarbonate in 2012 and a similarly alarming shortage of sterile saline solution in 2014.
As of today, on the FDA website, there are dozens of drugs said to be "currently in shortage," many of them critical generic injectables, like Epinephrine Injection, Lidocaine Hydrochloride (Xylocaine) Injection, and any number of injectable antibiotics.
Lidocaine HCL  used for localized pain relief in dental and other procedures is also in short supply...
Lidocaine HCL, used for localized pain relief in dental and other procedures is also in short supply.
JL Johnson
Several possible reasons for shortages
The experts, whoever they are, blame the shortages on a combination of factors, citing problems with getting raw materials. It leaves one to wonder how difficult it is to find salt or dextrose today. The experts also suggest the "issues" with aging facilities where many of these old drugs are manufactured and consolidation in the drug industry that has pushed many of the small companies out of business.
And as all of us well know, pharmaceutical companies are driven by profits, lots of them, and because generics are not profitable, many drug companies don't maintain supplies of many of these vitally important but inexpensive drugs.
The FDA is working with Pfizer and Amphastar to mitigate the shortage and a spokesperson for the agency said that it is “exploring all possible solutions to this critical shortage, including temporary importation, to help with this shortage until it’s resolved.”
More about Baking soda, sodium bicarbonate, Fda, current list, Importing
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