Mounting risk of a nuclear meltdown in Japan is triggering shortages of potassium iodide, a drug to help blunt the effect of radiation exposure, according to three companies approved to sell the treatment in the U.S.
Anbex Inc., based in Williamsburg, Virginia, sold out of its Iostat brand of the medicine yesterday, according to the company’s website. Jordbro, Sweden-based Recipharm AB makes its version, ThyroSafe, as orders come in and has no stock on hand, spokesman Mark Quick said. Fleming Pharmaceuticals in Fenton, Missouri, will run out its ThyroShield today, co-owner Deborah Fleming Wurdack said.
It’s unclear if a widespread release of radiation will occur in Japan, and treatment now won’t help people who encounter a blast days later, said Richard Zane, co-chair of emergency medicine at Brigham and Women’s Hospital in Boston. Personal stockpiles aren’t needed because emergency reserves are held in virtually every area that has a nuclear power plant, he said in a telephone interview.
“The issue with hoarding is you reduce availability for the people who need it for medical reasons,” Zane said. “The chance that you will need it is remarkably low, and the likelihood that you will need it and won’t have it is even lower because there are emergency stores and distribution plans in place in most developed countries.”
The potassium iodide should be given shortly before, or soon after, a nuclear accident to block the thyroid from absorbing radiation and reduce the risk of cancer, particularly in children, according to the World Health Organization. The danger is in direct proportion to the amount of exposure, making it imperative that people avoid radiation by moving away from the risk, staying indoors and washing off dust or debris that may contain radioactive particles, Zane said.
“In no case should the tablets be taken right away,” said Ilsa Bartenstein, chief executive officer of Gerot Lannach, an Austrian supplier of potassium iodide, in a telephone interview. “They’re only meant for use when one is in contact with radiation in an emergency.”
Side effects from potassium iodide include stomach upset, allergic reactions and rash. In rare cases, inflammation of the salivary glands can occur. The risks are higher in adults and the elderly, who may develop a goiter or hypothyroidism if they receive repeat doses, according to the U.S. Food and Drug Administration.
The radiation drug is also given to people with lung disorders to break up mucus and improve breathing. In addition, potassium iodide is used to shrink the thyroid before surgery to remove the gland, a treatment for certain cancers and for immune disorders that cause overproduction of thyroid hormones.
Closely held Fleming has 50,000 bottles of medicine in stock, only enough to meet demand through today, Wurdack said. Orders are coming in from all over the world, including China, Singapore, Korea and the U.S.
It could take weeks for the company to make more, Wurdack said. While raw potassium iodide is easy to get, she doesn’t know how quickly her supplier can produce large quantities of eye-droppers used to administer Fleming’s liquid version of the drug. Each 30-milliliter bottle contains 15 adult doses and costs $13.25, she said.
“It is absolute insanity here,” Wurdack said in a telephone interview. “We took hundreds of calls and hundreds of e-mails with orders and we haven’t even processed them yet. We are so far behind.”
Anbex won’t get additional supplies of its Iostat treatment until April 18, the closely held company said on its web site.
Recipharm sells ThyroSafe directly to consumers in the U.S., largely to people who live near nuclear reactors, said Quick, executive vice president of corporate development, in an interview. Its U.S. unit was established after the terrorist attacks of Sept. 11, 2001.
The company stopped taking orders in the U.S. because of high demand since the earthquake in Japan, Quick said. A voicemail message on the U.S. hotline tells customers to call back in 48 hours to check on product availability.
“One of the concerns is that radiation could come across to the U.S.,” Quick said. “That’s why we’re seeing such high demand there.”
Potassium iodide, which is relatively benign, is given to people who may be exposed to a radioactive iodine, said John Boice, professor of medicine at Vanderbilt University School of Medicine and scientific director of the International Epidemiology Institute in Rockville, Maryland. The thyroid absorbs the safer potassium iodide, leaving little room for the cancer-causing version to penetrate the gland, he said.
Thyroid damage, including cancer caused by radioactive iodine, is one of the biggest health threats from a nuclear meltdown, Boice said. Children are the most vulnerable because they are still growing and the thyroid is active, he said in a telephone interview. Treatment isn’t routinely recommended for people over age 40, he said.
“You don’t want to panic people, but I think we should be very watchful,” said Eula Bingham, professor of environmental health at the University of Cincinnati, who served on a committee for a 2006 National Academies report on the health risks from exposure to low levels of ionizing radiation. “I am most concerned about the children.”
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