Will Seattle see shortage of liquid albuterol for nebulizers?

The next few months may decide whether the shortage hits area hospitals, one UW Medicine expert says.  

Headlines over the last month have noted a national shortage of liquid albuterol. But Dr. Ryan Murphy, an asthma specialist at UW Medicine, says that the actual shortage isn’t clear-cut and may have gone unnoticed so far by Seattle-area patients.

Albuterol is an inhaled medication that works as a bronchodilator; it relaxes muscles in the airways to increase oxygen's flow to the lungs.

It’s a medicine commonly used inside the hospital and at home, generally as a “rescue medication” to alleviate symptoms that emerge quickly such as shortness of breath, chest tightness and wheezing, Murphy said. This occurs among patients with chronic lung diseases such as asthma or COPD, and also can accompany acute respiratory illnesses, he said.

He clarified that there is currently no shortage of the albuterol used in small canisters that one might carry in a pocket or purse.  The shortage of liquid albuterol started after one of two major manufacturers ceased production in February. 

“Some patients use liquid albuterol at home in a nebulizer, which creates a mist,” Murphy said. “But it’s much more commonly used inside the hospital in emergency or critical-care settings.”

UW Medicine pharmacies have not yet experienced a shortage, Murphy said. "(The hospitals) are not lending it out to other people. It seems like we're going to have ample supply.”

Most of his patients also have had no problems accessing albuterol for their home nebulizers, he said, though “I've told them to perhaps expect it over the coming months."

Murphy hopes patients in the Seattle area might avert this shortage. There is hope that new suppliers will enter the market in coming months and that supply chains will sort themselves out by fall and winter, when liquid albuterol is used most.

“Those are the times that patients are in the hospital with severe respiratory viral infections," Murphy said. “The hope is that the summer will give us a little bit of time to correct the shortage, and then, by the time the next respiratory virus season rolls around, we will be in good shape."

Alternative short-acting bronchodilator medications are just as effective, including a pharmaceutical cousin of albuterol called levalbuterol. It's less commonly used, but works as well, he said. Murphy also recommended that patients who suffer from asthma and other respiratory ailments reduce their exposure to environmental triggers known to worsen their symptoms, including indoor and outdoor allergens.  He stressed that patients should continue to take medications, such as inhaled corticosteroids with asthma, that really treat the underlying lung disease process that drives symptoms.

“Being adherent to those treatment regimens is really one of the most important things you can do to limit the need for albuterol,” he said.

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