Parenteral Multiple Vitamins Products Shortage Update

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:

  1. 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.
  2. 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).
  3. 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