Baxter has provided
ASPEN with an update of the status of their INFUVITE products. See Baxter’s Valued Customer Letter for more information.
ASPEN has developed
shortage considerations for Parenteral Multiple Vitamin Products to assist its members and other
clinicians in coping with shortages for their patients. These recommendations
were recently revised and include rationing and conservation strategies for
both adult and pediatric multiple vitamin products. Some of the considerations
for managing a shortage of intravenous multiple vitamin products include:
- The use of pediatric
intravenous multivitamins for adults is not recommended. Using pediatric
intravenous multivitamins for adults may contribute to a shortage of pediatric
products. A shortage of pediatric intravenous multivitamins could create a
potential risk of vitamin deficiencies in neonatal and pediatric patients that
may have an even greater need for vitamins. Furthermore, pediatric intravenous
multivitamins contain vitamins in doses or ratios that may be unsuitable for
adults.
- Assess each patient as
to the indication for PN and provide nutrition via the oral or enteral route
when possible. Consider switching to oral or enterally administered
multivitamins when oral/enteral intake is initiated (excluding patients with
malabsorption syndromes).
-
If intravenous
multivitamins are not available, administer individual parenteral vitamin
entities. Thiamine, ascorbic acid, pyridoxine, and folic acid should be given
daily. Thiamine is critical as several deaths have resulted from cardiac
failure due to thiamine deficiency when patients on long-term PN did not
receive vitamins for three to four weeks. Patients receiving a carbohydrate
load are particularly susceptible to thiamine deficiency.
Updated January 18, 2021