Shortage of 1% diclofenac gel

The American Society of Health-System Pharmacists reports a shortage of diclofenac in the form of a 1% gel. The US-approved version is made by only one company, Endo, with the brand name Voltaren. No reason for the shortage is given. This gel is applied to joints in the hands, wrists, elbows, knees, ankles, or feet to relieve the pain due to loss of joint cartilage and the underlying bone most common from middle age onward, aka osteoarthritis. There are various reasons to avoid taking diclofenac by mouth. If your doctor agrees, a compounding pharmacy can make the gel from the diclofenac contained in capsules.

Shortage of oxymorphone hydrochloride

The American Society of Health-System Pharmacists reports a shortage of oxymorphone hydrochloride. This drug shortage is due to Novartis' voluntary suspension of manufacturing at its Lincoln, Nebraska facility, where it manufactured this and several other drugs under contract with Endo. Their brand name formulation is Opana. As is all too common, Actavis and Roxane gave no reason for the shortage of the immediate release formulations that they manufacture. This drug is an opioid analgesic for moderate to severe pain. The chemical modifications made to the basic morphine structure produce less euphoria, sedation and itching. The low doses for immediate release are important for controlling so-called "break-through pain" for people who are already taking another opioid around the clock for the pain due to cancers, etc. Oxymorphone is also used to alleviate the panic due to lack of oxygen in people who are at the end of their life and are slowly suffocating as their lungs fill up with fluid. I recently read a good description of this in "Critical Care: A New Nurse Faces Death, Life, and Everything In Between," by Theresa Brown.

Drinking alcohol is foolish behavior for anyone taking an opioid analgesic, but it is particularly dangerous with oxymorphone. When tested in healthy volunteers, the blood concentrations of the drug varied from increases up to 270% to decreases down to -50%.