2 more cancer drug injectables fall into shortage

Multiple solutions of etoposide and topotecan are on back order.

Etoposide is an injectable used for testicular and small cell lung cancer, and topotecan is used for ovarian, cervical and small cell lung cancer. 

Six solutions for etoposide are on back order until spring, according to a drug supply database run by the American Society of Health-System Pharmacists. In 2022, Teva Pharmaceuticals stopped marketing the product. 

As of Jan. 31, Fresenius Kabi has two solutions available and Hikma Pharmaceuticals has one. Both drugmakers expect supply to rebound between March and May. Accord Healthcare said it could not estimate a release date. 

For topotecan, there is not enough supply for usual ordering of five solutions. Most drugmakers could not predict a resupply date, and Pfizer said its 1 milligram per milliliter, 4 milliliter vials should return in February. 

The ASHP recommends health systems evaluate their topotecan supplies before introducing the medication into patients' regimens. There is no No. 1 substitute, so clinicians should consult a cancer specialist and decide on treatment based on a patient's renal function, liver function, and the neoplasm type and location.

Other cancer drug injectables in shortage include dacarbazine, a skin cancer therapy, and Bacillus Calmette-Guerin, a bladder cancer drug that has been in short supply for years.

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