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Veterinarians scramble for mainstay chemotherapy drug

Doxorubicin hydrochloride in short supply


December 20, 2010
By: Jennifer Fiala
For The VIN News Service


A chemotherapy drug used as a first-tier treatment for lymphoma is in short supply, leaving veterinarians as well as human oncologists scrambling to get their hands on it.

News of a shortage of doxorubicin hydrochloride solution hit the Veterinary Information Network (VIN), a professional online community, last week when practitioners starting putting calls out for supplies. The shortage reportedly began mounting in September, with consumer media characterizing the drug's dry spell as the worse to hit human medicine in 30 years.

Doxorubicin hydrochloride is described by experts as one of the most effective single-agent treatments of cancer in dogs and people. Additionally, combination protocols that do not contain doxorubicin are not as effective for the treatment of lymphoma, explains Dr. Greg Ogilvie, a VIN consultant and boarded veterinary oncologist.

“It’s a very important drug,” he says. "Cancer patients depend on it.”

The shortage likely stems, in part, from manufacturing troubles identified by the U.S. Food and Drug Administration (FDA) at Teva Pharmaceuticals, one of the drug's makers. The FDA reports troubles at Teva are due to "manufacturing delays" on the agency's drug shortage page. Bedford Laboratories and APP Pharmaceuticals are the nation's other approved suppliers, and the FDA blames their back orders on "increased demand." Information provided by the FDA predicts the shortage will resolve by February, at the latest.

Officials with the three companies as well as FDA did not return immediate requests for more detailed information.

Unlike most veterinarians, Ogilvie, operating cancer centers in three different locations, isn't having significant trouble accessing doxorubicin. The reason for his access has to do with the volume of drug he orders. "We are certainly one of the largest veterinary users in the country," he says. "We're heavy buyers."

That still leaves most veterinarians with patients in need of doxorubicin in a pinch. Human medical facilities receive first access to new doxorubicin supplies. Once that pipeline is filled, access will widen for veterinarians. In the meantime, general practitioners and oncologists with limited access to the drug might turn to alternatives such as epirubicin, a structural analogue of doxorubicin. The tumoricidal activity of both drugs is similar.

Considering doxorubicin's lack of commercial availability, some are ordering a compounded version of the drug. Wedgewood Pharmacy, for example, offers doxorubicin HCl injection solution during the manufacturer backorder in 2mg/ml, 25ml multi-dose vials.



VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email news@vin.com.



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