Drug Availability

HPS Pharmacies wish to give notice that AstraZeneca is experiencing a supply interruption for pancuronium ampoules as follows:

Pancuronium Injection
Pancuronium bromide 4mg/2mL
ARTG 11964

Normal supplies are expected to resume on 25th July 2018.

Pancuronium is one of six non-depolarising neuromuscular blockers marketed in Australia. A summary of these agents, including the approximate onset and duration for recommended doses, can be found in Table 1. The duration of effect may be prolonged in patients with renal or hepatic impairment.

Table 1. Comparison of non-depolarising neuromuscular blockers

Drug

Onset (minutes)

Duration of action (minutes)

Availability

Initial Dose

Maintenance Dose

Aminosteroid Agents

Pancuronium

1.5-2.5

60-120

25-60

25th July 2018

Rocuronium

1

30-40

15-20

1st June 2018

Vecuronium

2-3

20-40

20-40

Currently available

Benzylisoquinolinium Agents

Atracurium

1.5

30-40

15-25

Currently available

Cisatracurium

2

30-40

20

Currently available

Mivacurium

2-2.5

15-30

15

Currently available

The benzylisoquinolinium agents lack vagolytic effects at recommended doses and, therefore, do not usually have clinically significant effects on heart rate. However, atracurium and mivacurium may cause histamine release which can result in flushing, hypotension, tachycardia, bronchospasm, and anaphylactoid reactions.

The appropriate product information should be consulted for further information before an alternative agent is selected.

Retain this notice in a prominent position, including in other related business units until supplies return to normal. Report any problems identified with medicines, vaccines or medical devices to the TGA.

Should you require further information regarding this matter, please contact your pharmacist at HPS Pharmacies, or AstraZeneca on 1800 226 591.

References:

  1. Pancuronium Injection BP. Australian approved product information. North Ryde: AstraZeneca. Approved March 2005.
  2. Rossi S, editor. Immunomodulators and antineoplastics. In: Australian Medicines Handbook 2018 [online]. Adelaide: Australian Medicines Handbook Pty Ltd; 2018.

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