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7/6/2024

Etomidate Injection

Products Affected - Description

    • Etomidate injection, Hikma, 2 mg/mL, 10 mL vial, 10 count, NDC 00143-9506-10
    • Etomidate injection, Hikma, 2 mg/mL, 20 mL vial, 10 count, NDC 00143-9507-10

Reason for the Shortage

    • Armas has etomidate injection available.[1]
    • Eugia has etomidate injection available.[2]
    • Fresenius Kabi has etomidate injection available.[3]
    • Fosun has etomidate injection available.[4]
    • Hikma has etomidate on shortage due to increased demand.[5]
    • Pfizer has etomidate injection available.[6]
    • Sagent discontinued etomidate in April 2023.[7]
    • Viatris (Mylan Institutional) has etomidate injection available.[8]

Available Products

    • Amidate injection, Pfizer, 2 mg/mL, 10 mL vial, 10 count, NDC 00409-6695-01
    • Amidate injection, Pfizer, 2 mg/mL, 20 mL vial, 10 count, NDC 00409-6695-02
    • Etomidate injection, Armas Pharmaceuticals, 2 mg/mL, 10 mL vial, 10 count, NDC 72485-0508-10
    • Etomidate injection, Armas Pharmaceuticals, 2 mg/mL, 20 mL vial, 10 count, NDC 72485-0509-10
    • Etomidate injection, Eugia US, 2 mg/mL, 10 mL vial, 10 count, NDC 55150-0221-10
    • Etomidate injection, Eugia US, 2 mg/mL, 20 mL vial, 10 count, NDC 55150-0222-20
    • Etomidate solution for injection, Fosun Pharma, 2 mg/mL, 10 mL vial, 10 count, NDC 72266-0146-10
    • Etomidate solution for injection, Fosun Pharma, 2 mg/mL, 20 mL vial, 10 count, NDC 72266-0147-10
    • Etomidate injection, Fresenius Kabi, 2 mg/mL, 10 mL vial, 10 count, NDC 65219-0445-10
    • Etomidate injection, Fresenius Kabi, 2 mg/mL, 20 mL vial, 10 count, NDC 65219-0447-10
    • Etomidate injection, Mylan Institutional (Viatris), 2 mg/mL, 10 mL vial, 10 count, NDC 67457-0902-10
    • Etomidate injection, Mylan Institutional (Viatris), 2 mg/mL, 20 mL vial, 10 count, NDC 67457-0903-20

Estimated Resupply Dates

    • Hikma has etomidate 2 mg/mL 10 mL and 20 mL vials on allocation.[5]

Implications for Patient Care

    • Etomidate is an injectable sedative medication used for the induction of general anesthesia and procedural anesthesia as well as supplementation of subpotent anesthetic agents. It has also been used for rapid sequence intubation.[9,10]

Safety

    • Etomidate is beneficial in its hemodynamic stability, when considering alternatives it is important to be aware of possible changes to hemodynamics.[11]

Alternative Agents & Management

    • Ketamine and propofol are common alternatives for etomidate. There are practice guidelines available for moderate procedural sedation and analgesia. These are available at https://pubs.asahq.org/anesthesiology/article/128/3/437/18818/Practice-Guidelines-for-Moderate-Procedural.

References

    1. Armas (personal communication). July 5, 2024.
    2. Eugia (personal communication). September 26, October 14, November 11, December 9 and 22, 2022; January 6 and 20, February 17, March 3, 16, and 31, April 17, May 26, June 9, July 10 and 21, August 4 and 31, October 27, December 19, 2023; April 15, May 15, and July 1, 2024.
    3. Fresenius Kabi (personal communication). September 30, October 28, November 19, December 2, 9, and 21, 2022; January 20 and 27, February 10 and 17, March 3, 10, and 17, April 7, 14, and 21, June 9 and 16, July 7 and 27, August 3, 10, 17, and 31, October 19, November 2 and 16, 2023; January 18, February 2, April 18, May 30, and July 5, 2024.
    4. Fosun (personal communication). November 22, 2022; March 7 and 17, April 24, June 8, July 10, August 11, October 19, November 3, 2023; and February 5, 2024.
    5. Hikma (personal communication). September 28, November 3 and 17, December 9 and 22, 2022; January 19 and 25, February 8, March 2, 8, and 15, April 6, 13, 20, and 26, May 25, June 8 and 15, July 5 and 27, August 2, 16, and 30, October 18, November 1 and 15, 2023; January 17, February 28, April 17, May 29, and July 3, 2024.
    6. Pfizer (personal communication). September 30, November 6 and 20, December 5, 14, and 22, 2022; January 22 and 27, February 12 and 20, March 6, 13, and 17, April 11, 18, and 23, May 1 and 31, June 9, July 10 and 26, August 13 and 19, and September 4, October 23, November 3 and 17, 2023; January 23, February 4, April 22, June 4, and July 5, 2024.
    7. Sagent (personal communication). September 29, November 3 and 17, December 9 and 12, 2022; January 19, February 9, March 2, and 9, and April 20, 2023.
    8. Viatris (personal communication). September 28, November 22, 2022; February 22, April 12, 19, and 24, May 2, June 1 and 6, July 11, August 28, October 9, 2023; January 22, 2024, and June 5, 2024.
    9. Amidate injection (etomidate) [prescribing information]. Lake Forest, IL: Hospira Inc; April 2022.
    10. Etomidate. Lexicomp Online. Wolters Kluwer Clinical Drug Information. Hudson, Ohio, USA. Accessed; Accessed July 13, 2023.
    11. Jellish WS, Edelstein S. Chapter 106 - Neuroanesthesia. In: Biller J, Ferro JM, eds. Handbook of Clinical Neurology. Vol 121. Neurologic Aspects of Systemic Disease Part III. Elsevier; 2014:1623-1633. doi:10.1016/B978-0-7020-4088-7.00106-1

Updated

Updated July 6, 2024 by Michelle Wheeler, PharmD, Drug Information Specialist. Created October 5, 2022 by Michelle Wheeler, PharmD, Drug Information Specialist. © 2024, Drug Information Service, University of Utah, Salt Lake City, UT.

Disclaimer

Drug Shortage Bulletins are copyrighted by the Drug Information Service of the University of Utah and provided by ASHP as its exclusive authorized distributor. ASHP and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information, and specifically disclaim all such warranties. Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this Bulletin. Neither ASHP nor the University of Utah endorses or recommends the use of any particular drug. Any application of this information for any purpose shall be limited to personal, non-commercial use.

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