The UK is currently experiencing temporary supply issues with some iodinated contrast media agents, due to manufacturing facilities operating at a severely reduced capacity as a result of recent COVID–19 lockdowns in China. Whilst it is anticipated that production capacity will increase in line with the gradual lifting of local restrictions over the coming weeks, the RCR is working closely with Specialist Pharmacy Service (SPS), the Society of Radiographers (SoR), NHS England and Improvement and the Department of Health and Social Care’s Medicine Supply Team to understand the extent of the supply issues, and to set out the key factors for consideration for imaging teams (e.g. radiologists, radiographers and associated professionals) and the services in which they work while the shortage remains.
Product lines affected
The principal products impacted at the present time are Iohexol (Omnipaque®) and Iodixanol (Visipaque®), both manufactured by GE Pharma.
The supplier has advised that they are consolidating production capacity around key product volumes in order to maintain supply, specifically 100ml of Omnipaque® 300 and 350, 100 ml of Visipaque® 320, and 500ml of Omnipaque® 350. The 500ml product is multi-dose and can be used for 24 hours once opened.
Action you can take
You and your service should consider taking the following actions to mitigate the risks associated with short and/or intermittent supply of Omnipaque® and Visipaque®, to ensure patient safety and the continuation of an effective imaging service:
- Be prepared to use a larger volume, multi-dose product in place of smaller volumes if feasible.
- Ensure any patient group directions relating to the implications of switching dose/product are reviewed/updated.
- If you already hold available stock of alternative iodinated contrast media, such as Iomerprol (Iomeron®) and Ioversol (Optiray®), consider using this instead.
- Consider alternatives to contrast-enhanced CT scans (e.g. MRI, ultrasound, or non-contrast CT). Ensure clinical teams are aware of this issue so that they can prioritise patients accordingly in conjunction with the imaging team.
- Increase the interval between follow-up imaging where appropriate and safe to do so.
- If the supply of contrast media is insufficient, collective clinical decision making will be required to determine which patient groups supplies should take priority (e.g. major trauma, new cancer diagnosis, critical care).
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