Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Other Income and Expenses [Abstract]
Professional fees	$ 2,523	$ 2,153
Interest expense	2,112	1,042
Payroll	1,392	1,908
Wholesaler fees	797	203
Medicaid and Medicare	440	383
Royalties	378	222
Rebates	363	714
Clinical studies	334	334
Inventory and Supplies	317	1,809
Capital expenditures	156	275
Income Tax	11	45
Other	480	754
Accrued expenses	$ 9,303	$ 9,842