"Updated September 2022

When shortages of antiepileptic drugs (AEDs) exist, there may be alternatives available. However, there are significant differences in product administration that may result in adverse drug events. Therefore, education of clinicians is necessary to limit risks to the patient. In this alert, we will discuss five commonly used IV AEDs: fosphenytoin/phenytoin, lacosamide, levetiracetam, valproic acid, and phenobarbital, which is an alternative therapy when other AEDs are not available. This summary provides information in the event of a shortage(s) and its impact on adult and pediatric patients by providing potential management strategies, pharmacotherapeutic considerations, and safety implications. The recommendations provided here are based on both current evidence, including a review of available literature by the SCCM Drug Shortages and Medication Safety Committee, and the need for conservation during this shortage.

Recommendations and information provided in this Drug Shortage Alert are compiled by experts in the field. Practitioners are advised to consult with their institution’s staff to ensure that response to any drug shortage is in line with internal policies and procedures.
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