With the government shutdown, many telehealth visits are not currently covered by Medicare. We are contacting impacted patients to help you avoid any unexpected charges. In many cases, telehealth appointments can be changed to an in-person visit. Please contact your clinic if you have questions or want to change or reschedule an appointment.
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Pharmacy Alerts
Iron Dextran
There is a national drug shortage on iron dextran with no further release date. Please consider using another iron formulation such as iron sucrose (Venofer) or ferumoxytol (Feraheme) during this shortage.
IV/IM Lorazepam
We are unfortunately facing a critical shortage of IV/IM lorazepam (2mL vials) and down to a limited supply (<1-2 weeks). We will be implementing an EPIC alert but wanted to also notify you directly due to the far reaching nature of this shortage.
For clinical scenarios that require IV/IM lorazepam critically (e.g. status epilepticus): please proceed with order. Otherwise, some options for managing this shortage include:
• Utilize PO lorazepam whenever possible (dosing conversion is 1:1).
• For ED/CCU/procedural areas – consider utilizing midazolam if able.
• For med/surg areas, consider IV diazepam (avoid IM due to erratic absorption) if able.
NOTE: There are no direct dosage conversions between the benzodiazepines because each has a distinct pharmacokinetic profile that dictates the agent's therapeutic use and dosing. Below are conservative recommendations and information regarding the onset and duration.
Questions? Contact Sharon_Lu@valleymed.org