Buprenorphine
Manufactured buprenorphine has been on backorder for several months. This includes Simbadol® 1.8 mg/mL injection and the human product, buprenorphine 0.3 mg/mL injection.
The current estimate for release of the 0.3 mg/mL buprenorphine is mid-June to mid-July 2026. Simbadol® is expected back sooner but is still not available as of this writing.
During the shortage, the most viable alternative is compounded buprenorphine from a reputable compounding pharmacy. Check applicable state laws for using compounded medications as office stock.
There are compounded options available for both injectable and oral transmucosal routes. These should not be used interchangeably.
Clevor®
Clevor® (ropinirole) 30mg/ml ophthalmic solution has also been on backorder for several months. During the shortage, the most viable option to induce vomiting in dogs is apomorphine, a dopamine agonist. (Apomorphine is ineffective in cats.) This medication is com-pounded for veterinary use and is available at some compound-ing pharmacies for office use (check state laws).
Apomorphine induces vomiting in ≥ 90% of cases and is about 75% effective in removing an ingested foreign body by vomiting. It is dosed at 0.01 to 0.04mg/kg SC, IM, or IV. Emesis induction is quickest with IV administration (1 to 5 minutes), followed by SC (2 to 32 minutes). The intramuscular route is less desirable due to longer time to produce emesis and decreased efficacy.
Side effects include prolonged nausea and/or vomiting. Other adverse effects tend to be mild, with sedation and inappetence being the most common.
The patient should be monitored for dehydration and cardiac function. Caution should be used in patients with renal or hepatic dysfunction. The duration of effect is generally about 30 to 45 minutes but can last up to 2½ hours. Since apomorphine is a derivative of morphine, naloxone can be used to reverse the respiratory and CNS effects. However, naloxone will not reverse the cardiac or vomiting effects.
Source: app.plumbs.com/drug/ 9113HOC31WPROD?source=search&-searchQuery=apomor
