We have been informed by our Pharmacy colleagues there is another world-wide shortage of Synacthen.
Supplies are unlikely to become available until the end of May.
So, we need to develop strateries with our endocrinology colleagues as to how best to look after/diagnose a patient with suspected adrenal insufficiency during this time.
Current advice locally is if random Cortisol is >350nmol/L, adrenal insufficiency is unlikely so no further testing.
If random Cortisol is <250nmol/L, then adrenal insufficiency cannot be excluded, so they would be suggesting cover with hydrocortisone (10mg+5mg)daily until SST can be performed.
So, our report comments will need to mirror this advice, plus advising requesters they seek an endocrine opinion before embarking on the latter course of action.
Has anyone else been informed of this issue, and if so, what are you proposing to do to ensure patient care is not compromised?
Gary Mascall
Worcestershire Acute Hospital NHS Trust.
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