Medical Forum
Medicine shortage a chance to review asthma prescribing
A nation-wide shortage of asthma medications provides an opportunity for healthcare practitioners to review their prescribing practices.
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Medical Forum
GPs and other practitioners are urged to review their asthma prescribing as shortages of some salbutamol nebules look likely to continue until December.
GSK has advised of a current supply shortage of Ventolin Nebules (salbutamol sulfate) 5 mg/2.5 mL and 2.5 mg/2.5 mL inhalation solution ampoules.
The out of stock period for the 5 mg/2.5 mL inhalation solution ampoules is currently anticipated until August 17, while the 2.5 mg/2.5 mL inhalation solution ampoules have limited availability until December 21.
An alternative brand is available for salbutamol 5mg/2.5mL, according to a notice from the Therapeutic Goods Administration (TGA).
For both products the TGA has also approved an overseas registered product for use while shortages continue.
The National Asthma Council (NAC) said the shortages reinforced the need to implement the updated Asthma Handbook.
Clinical Associate Professor Debbie Rigby, Clinical Executive Lead at the NAC, said: “While this may be distressing for patients with asthma who have been using this medication, the shortage also provides an opportunity for health professionals to reinforce the updated guidelines.
“No adult or adolescent should be using short-acting beta2 agonist (SABA-only) treatment and the emphasis is now on embedding anti-inflammatory reliever (AIR-only) and maintenance-and-reliever therapy (MART) approaches as standard care for adults and adolescents.”
Prof Rigby said it was important for health practitioners to also communicate to patients that salbutamol delivered via nebuliser requires a higher dose without any added therapeutic benefit.
Nebulisers are less portable as they may require a power source to run and take a longer time to deliver a dose of salbutamol. Patients often need to wait up to 10 minutes for the dose to be administered.
Prof Rigby added that the recommendations to avoid SABA-only treatment and shift towards inhaled corticosteroids (ICS-containing) therapy for all adults and adolescents requires substantial education and behaviour changes for patients.
“Pressurised metered-dose inhalers (pMDIs) with a spacer is at least as effective as a nebuliser for the delivery of salbutamol for adults and children, even during symptomatic exacerbations,” she said.
“We encourage all health professionals to talk to their patients about the importance of focusing on alleviating chronic inflammation in the airways, not just addressing symptoms.”
The National Asthma Handbook and other resources are available on National Asthma Council Australia's website.