FW: Diltiazem Shortage – Metoprolol Substitution

Good afternoon, everyone. Please read the below message from Capt. Hopkins regarding the TRANSITION to metoprolol from Cardizem.
When you use your Cardizem, you will now replace it with metoprolol from the pyxis. Do NOT carry both.
Capt. Hopkins’ email has more important information about quantity and administration, and the protocol is attached for reference.
I encourage local shift training scenarios as this transition occurs. Reach out to your local supervisor if you have any questions or want to complete training.

<www.washco-md.net/emergency-services/>
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 240-527-5940 (office) 240-313-2911 (fax) 240-313-4375 www.washco-md.net<www.washco-md.net/>
From: Hopkins, Lauren <[email protected]> Sent: Wednesday, March 11, 2026 12:55 PM To: Higgins, Melanie <[email protected]> Subject: Fw: Diltiazem Shortage – Metoprolol Substitution
Mel,
Can we send this out to the ALS clinicians in the county please? It looks like I’m going to have to have pharmacy stock this in pyxis today.
Attention ALS providers:
We will be adding a new medication to pyxis and to our units. Metoprolol is replacing the Diltiazem ADDvantage as the manufacturer has stopped producing it. Please also note the rate of administration…it is a SLOW IVP over 2 minutes at minimum.
Units can replace their Diltiazem with 2 vials of Metoprolol (5mg/5ml vials) at the pyxis as they use it or as it expires. Please do NOT just go pull this medication-it is being utilized to replace Cardizem and units should not be carrying both meds.
Clinicians should make themselves familiar with the attached protocols regarding this new medication.
Any questions please do not hesitate to reach out.
Thank you,
Lauren Hopkins
Captain
Division of Emergency Services
16232 Elliott Parkway
Williamsport, MD 21795

________________________________ From: Chisholm, David E. <[email protected]<mailto:[email protected]>> Sent: Monday, February 23, 2026 4:39 PM To: Hopkins, Lauren <[email protected]<mailto:[email protected]>> Subject: FW: Diltiazem Shortage – Metoprolol Substitution
These documents should tell you what we need to know about the metoprolol concentration.

David E. Chisholm, RN, BSN, NRP
Deputy Director – Operations
Division of Emergency Services
16232 Elliott Parkway
Williamsport, Maryland 21795

Office (240) 313-2906
Cell (240) 500-5045
Fax (240) 313-4375
www.washco-md.net<www.washco-md.net/>

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Good afternoon,

Please refer to the attached memorandum and supporting protocols in reference to a medication shortage/discontinuance.

Direct any questions to Dr. Chizmar. Thank you.

Regards,

Stephanie J. Ermatinger

Stephanie J. Ermatinger
Administrative Officer III
Office of State EMS Medical Director, Dr. Timothy Chizmar
Office of State Aeromedical Director, Dr. Doug Floccare
Office of Care Integration Director, Chief Kenny Barajas
MD Institute for <192.168.110.213/home/omd> Emergency Medical Services Systems<192.168.110.213/home/omd> 653 West Pratt Street, 4th Floor
Baltimore, MD 21201
410.706.0881 (Office) 410.982.8009 (Mobile)
[email protected]<mailto:[email protected]>
[email protected]<mailto:[email protected]>

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From: Timothy Chizmar <[email protected]<mailto:[email protected]>> Sent: Tuesday, December 16, 2025 2:53 PM To: Stephanie Ermatinger <[email protected]<mailto:[email protected]>> Subject: Diltiazem Shortage – Metoprolol Substitution

Stephanie,

Please distribute the memo and attached documents to:

JAC
Medical Directors
Commercial Services via Scott Legore.

Thank you,

Timothy P. Chizmar, MD, FACEP, FAEMS
State EMS Medical Director
Maryland Institute for Emergency Medical Services Systems
653 West Pratt Street
Baltimore, Maryland 21201

Email: [email protected]<mailto:[email protected]>
Office: 410-706-0880
www.miemss.org<www.miemss.org/>

11.XX-Metoprolol-Tartrate-p256-257-Revised.pdf

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