Asthma Drug Albuterol Shortage Is About To Worsen: Here’s Why—And How Hospitals Are Filling The Gaps

Several major manufacturing plants for the asthma and respiratory drug Albuterol have shut down, possibly worsening an already-flaring shortage of the medication that has forced hospitals to devise alternatives.

Close-up of human hand of a man holding an albuterol sulfate inhaler.

Albuterol is used in inhalers and nebulizers to treat patients with breathing problems and illnesses like asthma and respiratory syncytial virus (RSV) by helping with wheezing, difficulty breathing, coughing, shortness of breath and chest tightness, according to the federally funded National Library of Medicine's MedlinePlus.

One of the major liquid albuterol suppliers—Akorn Pharmaceuticals—filed for chapter seven bankruptcy and shut down at the end of February, reportedly closing its plants in New Jersey, Illinois and New York and worsening an ongoing drug shortage, especially for U.S. hospitals.

There is now only one domestic albuterol manufacturer: Nephron Pharmaceuticals began shipping the drug last Friday, but it's on backorder, Paula Gurz, senior director of pharmacy contracting with Premier Inc., a major group purchasing company for hospitals, told CNN.

The drug has been listed on the Food and Drug Administration's shortage list since October 2022, joining other medications used to fight off RSV like children's Tylenol, Advil and Motrin.

As the transition from winter to spring commences and the surge in respiratory illnesses like RSV, the flu and Covid subsides, experts fear the shortage will spell out trouble for this year's upcoming allergy season.

Angela Folger, the director of pharmacy at Nemours Children's Hospital told the Washington Post this is the worst drug shortage she's seen in her "almost 20-year career."

According to a study published in Pharmacy, albuterol is among the top 10 most prescribed medications in the U.S.

25 million. That's how many people in the U.S. have asthma, according to the Asthma and Allergy Foundation of America, totaling around one in 13 Americans. Asthma affects more women as 9.8% of women have it, compared to 6.1% of men.

Albuterol experienced a shortage in 2020 at the start of the Covid pandemic. The American College of Allergy, Asthma and Immunology advised the public to first check inhalers to ensure they still had medicine, and recommended using expired inhalers if necessary as they may still be partially effective. If a patient can't get a refill on their metered dose inhaler, the ACAAI recommends contacting health care providers or allergists for alternative medications. Lastly, the ACAAI warns not to overuse inhalers as one canister should last for months. As for hospitals, some have been monitoring their supply closely as there's concern there will be an uptick in emergency room patients coming in with breathing problems, or a delay in discharging patients because there's not enough medicine. According to CBS News, hospitals have turned to a process called compounding, or combining, altering or mixing ingredients or drugs to make a medication tailored for patients. Some hospitals have been using levalbuterol as an alternative, which can also be used in a nebulizer or inhaler to treat breathing problems. Julianne Bardele, a spokesperson for Lurie Children's Hospital in Chicago, told CNN the hospital has resorted to squeezing out smaller packages of albuterol, a time-consuming process.

Albuterol comes as a liquid to be used in a nebulizer (a machine that turns liquid medicine into a mist that can be easily inhaled via a face mask or mouthpiece), or an aerosol or powder to be used in an inhaler. According to MedlinePlus, the nebulizer solution is used between three or four times a day. An inhaler used to treat breathing problems during physical activity is used 15 to 30 minutes before activity, and used every four to six hours when prescribed to prevent symptoms of lung disease. Each aerosol inhaler has about 60 to 200 uses, and the powder inhalers are designed to provide 200 inhalations.

Here's Why There Is A Shortage For Children's Tylenol, Advil And Motrin—And What To Do About It (Forbes)

A shortage of albuterol is about to get worse, especially in hospitals (CNN)

READ IT: Akorn layoff letter to employees (Herald & Review Illinois)

Shortage of asthma drug albuterol worsens amid factory closures (The Hill)

The albuterol shortage is about to get worse (Washington Post)