NPSA- Shortage of salbutamol

National Patient Safety Alert: Shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid unit dose vials

A Medicines Supply Notification (MSN) issued on 14 February 2024, detailed a shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid. The resolution date is to be confirmed.

The supply issues have been caused by a combination of manufacturing issues resulting in increased demand on other suppliers.

Terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remain available, however, they cannot support an increase in demand.

Ventolin® (salbutamol) 5mg/ml nebuliser liquid (20ml) is out of stock until mid-April 2024 and cannot support an increased demand after this date.

Unlicensed imports of salbutamol nebuliser liquid can be sourced. Lead times vary. Information relating to imports was outlined in the MSN and is available on the SPS Medicines Supply Tool which also details any changes to resupply dates, updates to this communication and an up-to-date supply overview

Actions required by all organisations:

Actions to be completed as soon as possible and not later than 8 March 2024.

All providers MUST:

• Liaise with local pharmacy teams and place urgent orders for unlicensed imports of salbutamol nebuliser liquid – do not wait for supplies to be exhausted before placing orders for imports.
• Wean all patients off nebulisers as soon as their condition has stabilised.
• Consider use of high-dose salbutamol pressurised metered-dose inhaler (pMDI) via a large volume spacer in patients with mild to moderate asthma attacks or COPD (see clinical information) ensuring the patient is issued with a new inhaler to avoid risk of using a near empty device and can administer it effectively if not being administered by a healthcare professional.

Primary care providers should:

• Review need for home nebuliser use, and if deemed necessary, determine if the patient has sufficient supplies of nebuliser liquid at home before issuing repeat prescriptions.

Details of the alert can be found here.