Distribution and manufacturing problems and increased demand during a springtime allergy season apparently have triggered a shortage of a popular asthma inhaler at some Kingman-area pharmacies.
"The supply of the (bronchial dilator) product has been erratic for six months or more," said Paul Lewis, who owns three pharmacies in the Kingman area.
"We have a number of sources.
We are able to get them in stock."
At least one Kingman chain store was not so lucky when it came to stocking the bronchial dilator, which is sold under the brand names Proventil (manufactured by Schering-Plough) and Ventolin (Glaxo) and generically as albuterol.
The drugstore ran out of the inhalers as of Saturday and did not restock the medication until Tuesday.
"It wasn't too long," store pharmacist Kris Lehew said.
"It was intermittent.
It's all due to manufacturing problems.
There is not much you can do if the supply does not meet demand.
"We just continue to order it daily," Lehew said.
"We were directing those (customers) who were totally out (of the drug) to other pharmacies (in town)."
Lewis said he received referrals from other pharmacies, adding he considers a shortage of albuterol serious because it is the most frequently prescribed drug for respiratory problems such as asthma and emphysema.
He estimated that as many as1,000 units of the albuterol inhalers sell each month in the Kingman area.
Chain-store pharmacist Fernando Velez said his store does not face a shortage now.
"We're expecting it," Velez said.
"We have received messages from the manufacturer and our corporate headquarters to start attempting to stockpile it.
We order every day so that we can continue to keep getting some in."
Supermarket pharmacist Jim Isom said he has received 10 to 12 referrals from other pharmacies in recent weeks.
Isom and Dirk Lehew, a pharmacist at a competing supermarket and the husband of Kris Lehew, said demand is high for the medication because of the allergy season.
Neither store has encountered shortages.
Velez said he expects all pharmacies in Kingman to face shortages because only one manufacturer, Warrick, makes AB-rated albuterol inhalers.
The rating means that the drug has been tested and proven by the federal Food and Drug Administration to be therapeutically equivalent to brand-name products.
Warrick accounts for 55 percent to 60 percent of the domestic market for albuterol inhalers, said Bob Consalvo, director of external communications at parent company Schering-Plough's corporate headquarters in Kenilworth, N.J.
He said Proventil accounts for only 2 percent to 3 percent of market share.
"We are not the only manufacturer, but we are manufacturing and shipping our products to the distributors and wholesalers, our trade customers," Consalvo said.
"We are making the products as we always make them.
There are from time to time imbalances on a regional level, at the distributor level."
That has triggered temporary shortages in some areas of the country, he said.
"I don't know why there is a shortage in your area," he said.
FDA spokeswoman Laura Bradbard in Rockville, Md., said spot shortages have occurred throughout the country.
FDA physicians and pharmacists investigate reported shortages.
"Sometimes a shortage will be reported when there is a particular package of a drug or a version," Bradbard said.
"There have been manufacturing problems."
FDA staff work with distributors and wholesalers to alleviate shortages, Bradbard said.
Kingman Regional Medical Center has not encountered any shortage of the medication, said Marty Cowan, director of development and community relations.
"The pharmacist is aware of the national problem, but by using other vendors and national suppliers, we have not experienced any shortages at the hospital," he said.