Shortage of injectable dexrazoxane

The American Society of Health-System Pharmacists reports a shortage of injectable dexrazoxane. After a woman has received a total of 300 mg/square meter body surface area of doxirubicin for her breast cancer, dexrazoxane is added to the treatment in order to protect her heart from the damage that is a side effect of doxirubicin. Zinecard, the Pfizer brand of this drug, has been in short supply because the sodium lactate they provided to dissolve the dexrazoxane contained particulate matter. In a June 7, 2011 letter (PDF) to health care providers, Pfizer presented their solution to this problem, an alternate procedure for first dissolving Zinecard in sterile water for injection and then in lactated Ringer's solution. On November 19, 2011, however, the Bedford Labs generic version manufactured at Ben Venue Labs became unavailable because of the voluntary shutdown of that facility for equipment maintenance and requalification.

The newly approved dilution procedure for Zinecard gives rise to a possible source of confusion and error, because the Mylan and Bedford generic dexrazoxane is only approved to be dissolved in the sodium lactate solution provided with them.