RALEIGH, N.C. (WNCN) – A local clinic is calling the shortage of a much-needed drug a crisis.

The combination of injectable lidocaine with epinephrine is widely used by doctor’s offices all over the country. It’s necessary for many outpatient surgeries.

Sterile injectables, like lidocaine, are in central North Carolina at Pfizer’s Rocky Mount facility.

Raleigh Skin Surgery Center performs outpatient surgery on patients with cancerous skin tumors. Dr. Tamara Housman said the short supply of injectable lidocaine with epinephrine is having a major impact on her practice, as well as others across the country.

“It’s like gold. You know we only try to use as much as we need. We can’t spare a single unit of it,” Housman said. “We use lidocaine with epinephrine almost exclusively. Lidocaine is by far the safest form of local anesthesia. It provides instant numbing. It’s a very predictable response. We are very comfortable using it.

“The epinephrine component helps with bleeding. It constricts the blood vessels where you inject it so you get less bleeding. You can perform the surgeries safer. I can see better during the surgery so the epinephrine us a very important component.”

Housman said the shortage started as far back as March of 2017.

“By August, we were down to a two-week supply of lidocaine and we were really scrambling trying to figure out what we were going to do. (We were) calling hospitals, calling pharmacies,” Housman explained.

In the middle of 2019, it’s even worse. Housman said it’s manufactured only 47 miles at Pfizer’s plant in Rocky Mount.

“We experienced a delay in release of certain lidocaine presentations, but have started to release some additional presentations last week, earlier than previously anticipated,” a Pfizer spokesperson said. “We are communicating availability to our customers. We expect to fulfill most back orders, and there may be some intermittent supply delays.” 

Pfizer didn’t explain why there is an issue. Housman said she’s been getting the same explanation for years.

“When you go online to order it, for example, it will say it’s on back order expected availability whatever date,” Housman said. “And then you try back a couple of days later and that date has now changed. It’s moved from, let’s say, June to July and then it moves to August. And they just keep changing it and there is no answer as to a definitive date or why this is moving. They just say we don’t know, the manufacturer doesn’t have it.

“Well, it turns out there’s only one manufacturer in this country and they’re undergoing, I think, a major overhaul in their manufacturing process which has caused this delay.”

The Federal Drug Administration directed information requests to its drug shortage webpage. In one column, it says the drug is available. In another column, it says there’s a manufacturing delay.

Clicking the option to see the letter sent to customers says “page not found.”

“I would like the FDA to take control of what’s happening. Own up to it and say we’re going to put a different method in place where we don’t rely on one manufacturer for these potentially life-saving drugs,” Housman said. “Here we are, the richest country in the world, and we can’t provide these very basic injectable drugs that are not expensive to manufacture.”

When the Skin Surgery Center does get a supply, there tends to be only a short window of time to use it before the expiration date.

“This practice would absolutely have to shut down if we didn’t have it. We can’t do it. We can’t do our work without it” said Housman.

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