Skip to main content Back to Top
Advertisement

11/21/2022

Lidocaine Injection

Products Affected - Description

    • Xylocaine injection, Fresenius Kabi, 1%, 20 mL vial, 25 count, NDC 63323-0485-27
    • Xylocaine injection, Fresenius Kabi, 1%, 50 mL vial, 25 count, NDC 63323-0485-57
    • Xylocaine injection, Fresenius Kabi, 2%, 10 mL vial, 25 count, NDC 63323-0486-17
    • Xylocaine injection, Fresenius Kabi, 2%, 20 mL vial, 25 count, NDC 63323-0486-27
    • Xylocaine injection, Fresenius Kabi, 2%, 50 mL vial, 25 count, NDC 63323-0486-57
    • Xylocaine-MPF injection, Fresenius Kabi, 0.5%, 50 mL vial, 25 count, NDC 63323-0491-57
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 10 mL sterile-pack ampule, 5 count, NDC 63323-0492-97
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 2 mL vial, 25 count, NDC 63323-0492-27
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 30 mL vial, 25 count, NDC 63323-0492-37
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 5 mL vial, 25 count, NDC 63323-0492-57
    • Xylocaine-MPF injection, Fresenius Kabi, 1.5%, 10 mL ampule, 5 count, NDC 63323-0493-97
    • Xylocaine-MPF injection, Fresenius Kabi, 1.5%, 20 mL ampule, 5 count, NDC 63323-0493-91
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 10 mL ampule, 5 count, NDC 63323-0496-97
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 2 mL vial, 25 count, NDC 63323-0495-27
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 5 mL vial, 25 count, NDC 63323-0495-07
    • Lidocaine Hydrochloride injection, Amphastar, 2%, 5 mL Luer-Jet Emergency syringe, 10 count, NDC 76329-3390-01
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 10 mL vial, 25 count, NDC 55150-0251-10
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 2 mL ampule, 10 count, NDC 55150-0158-72
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 2 mL vial, 10 count, NDC 55150-0161-02
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 20 mL vial, 25 count, NDC 55150-0252-20
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 30 mL vial, 1 count, NDC 55150-0163-30
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 5 mL ampule, 10 count, NDC 55150-0159-74
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 5 mL vial, 10 count, NDC 55150-0162-05
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 10 mL vial, 25 count, NDC 55150-0254-10
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 2 mL ampule, 10 count, NDC 55150-0160-72
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 2 mL vial, 10 count, NDC 55150-0164-02
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 20 mL vial, 25 count, NDC 55150-0255-20
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 5 mL vial, 10 count, NDC 55150-0165-05
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 50 mL vial, 25 count, NDC 55150-0256-50
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 1%, 10 mL vial, 25 count, NDC 63323-0201-10
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 1%, 2 mL vial, 25 count, NDC 63323-0201-02
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 2%, 2 mL vial, 25 count, NDC 63323-0202-02
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 2%, 5 mL Tear-top preservative-free vial, 25 count, NDC 63323-0208-05
    • Lidocaine Hydrochloride injection, Hikma, 1%, 5 mL preservative-free vial, 25 count, NDC 00143-9595-25
    • Lidocaine Hydrochloride injection, Hikma, 1%, 50 mL vial, 10 count, NDC 00143-9577-10
    • Lidocaine Hydrochloride injection, Hikma, 2%, 5 mL preservative-free vial, 25 count, NDC 00143-9594-25
    • Lidocaine Hydrochloride injection, Hikma, 2%, 50 mL vial, 10 count, NDC 00143-9575-10
    • Lidocaine Hydrochloride injection, Pfizer, 0.5%, 50 mL SD Tear Top preservative-free vial, 25 count, NDC 00409-4278-01
    • Lidocaine Hydrochloride injection, Pfizer, 0.5%, 50 mL SD Flip Top vial, 25 count, NDC 00409-4275-01
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 2 mL preservative-free glass ampule, 50 count, NDC 00409-4713-32
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 20 mL vial, 25 count, NDC 00409-4276-01
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 30 mL preservative-free vial, 25 count, NDC 00409-4279-02
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL emergency Ansyr syringe, 10 count, NDC 00409-9137-05
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL LifeShield syringe, 10 count, NDC 00409-4904-34
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 50 mL vial, 25 count, NDC 00409-4276-02
    • Lidocaine Hydrochloride injection, Pfizer, 1.5%, 20 mL preservative-free ampule, 25 count, NDC 00409-4776-01
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 10 mL preservative-free glass ampule, 25 count, NDC 00409-4282-02
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 2 mL preservative-free glass ampule, 25 count, NDC 00409-4282-01
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 20 mL vial, 25 count, NDC 00409-4277-01
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL emergency Ansyr syringe, 10 count, NDC 00409-1323-05
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL LifeShield syringe, 10 count, NDC 00409-4903-34
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL preservative-free vial, 10 count, NDC 00409-2066-05
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 50 mL vial, 25 count, NDC 00409-4277-02
    • Lidocaine Hydrochloride injection, Pfizer, 4%, 5 mL preservative-free glass ampule, 25 count, NDC 00409-4283-01

Reason for the Shortage

    • Amphastar has lidocaine syringes on shortage due to increased demand.
    • Eugia has lidocaine on shortage due to increased demand.
    • Fresenius Kabi has lidocaine on shortage due to increased demand.
    • Pfizer has lidocaine presentations on shortage due to manufacturing delays and increased demand.

Available Products

    • Xylocaine injection, Fresenius Kabi, 0.5%, 50 mL vial, 25 count, NDC 63323-0484-57
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL preservative-free glass ampule, 50 count, NDC 00409-4713-02

Estimated Resupply Dates

    • Amphastar has 2% lidocaine 5 mL syringes on back order and the company cannot estimate a release date.
    • Eugia has all lidocaine presentations on intermittent back order and the company is releasing product as it becomes available.
    • Fresenius Kabi has 0.5% Xylocaine-MPF 50 mL vials on back order and the company estimates a release date of late-November to early-December 2022. The 1% lidocaine 2 mL and 10 mL vials are on back order and the company estimates a release date of early-December 2022 for the 2 mL vials and late-November to early-December 2022 for the 10 mL vials. The 1% Xylocaine 20 mL and 50 mL vials are on back order and the company estimates a release date of mid-December 2022 for the 20 mL vials and late-November to early-December 2022 for the 50 mL vials. The 1% Xylocaine-MPF 2 mL vials, 5 mL vials, and 30 mL vials are on back order and the company estimates a release date of early-December 2022 for the 2 mL vials, late-November 2022 for the 5 mL vials, and late-November to early-December 2022 for the 30 mL vials. The 1% Xylocaine-MPF 10 mL vials in sterile packs are on back order and the company estimates a release date of late-November to early-December 2022. The 1.5% Xylocaine-MPF 10 mL and 20 mL ampules are on back order and the company cannot estimate a release date. The 2% Xylocaine 10 mL, 20 mL, and 50 mL vials are on back order and the company estimates a release date of early-December 2022 for the 10 mL, mid-December 2022 for the 20 mL vials, and late-November to early-December 2022 for the 50 mL vials. The 2% Xylocaine-MPF 2 mL and 5 mL vials are on back order and the company estimates a release date of early-December 2022 for the 2 mL vials and mid- to late-December 2022 for the 5 mL vials. The 2% Xylocaine-MPF 10 mL ampules are on back order and the company cannot estimate a release date. The 2% lidocaine 2 mL and 5 mL vials are on back order and the company estimates a release date of early-December 2022 for the 2 mL vials and late-November to early-December 2022 for the 5 mL vials.
    • Hikma has the 1% lidocaine 5 mL and 50 mL vials on back order and the company estimates a release date of mid-December 2022. The 2% lidocaine 5 mL and 50 mL vials are on allocation.
    • Pfizer has 0.5% lidocaine 50 mL flip top vials on back order and the company estimates a release date of November 2023. The 0.5% lidocaine 50 mL tear top vials are on back order and the company estimates a release date of December 2022. The 1% lidocaine 20 mL and 50 mL vials are on back order and the company estimates a release date of November 2022 for the 20 mL vials and January 2023 for the 50 mL vials. The 1% lidocaine 30 mL preservative-free vials are on back order and the company estimates a release date of March 2023. The 1% lidocaine 2 mL ampules are on back order and the company estimates a release date of November 2022. The 1% lidocaine 5 mL Ansyr syringes and 5 mL LifeShield syringes are on back order and the company estimates a release date of November 2022. The 1.5% lidocaine 20 mL ampules are on back order and the company estimates a release date of December 2022. The 2% lidocaine 2 mL preservative-free ampules are on back order and the company estimates a release date of November 2022. The 2% lidocaine 10 mL ampules are on back order and the company estimates a release date of December 2022. The 2% lidocaine 5 mL, 20 mL, and 50 mL vials are on back order and the company estimates a release date of January 2023 for the 5 mL and 20 mL vials and December 2022 for the 50 mL vials. The 2% lidocaine 5 mL Ansyr syringes are on back order and the company estimates a release date of November 2022. The 2% lidocaine 5 mL LifeShield syringes are available in limited supply. The 4% lidocaine 5 mL ampules are on back order and the company estimates a release date of November 2022.

Alternative Agents & Management

    • Bupivacaine and lidocaine are amide-type local anesthetics commonly used in clinical practice. The following table compares their pharmacodynamic and pharmacokinetic properties. Key differences between the products are onset of action, duration of action, and dose. In general, bupivacaine is a longer-acting local anesthetic, while lidocaine has a more rapid onset, but shorter duration of action.[1-2]
    Table 1. Table. Comparison of Bupivacaine and lidocaine for Local Anesthesia1-6
    PropertyBupivacaineLidocaine
    *Duration of effect is prolonged by use of local anesthetics in combination with epinephrine, although magnitude of effect is not well-defined for all routes.
    Onset of actionInfiltration: 2-10 min
    Epidural: 4-7 min
    Spinal: 1-15 min
    Not well-defined for anesthetic use as a single agent.
    In general local analgesia 1 to 3 min
    Spinal and Epidural rapid onset
    Duration of action:
    As a single agent
    Infiltration: 2-8 h
    Nerve block, minor: 3-6 h
    Epidural: 3-9 h
    Spinal: 1.5-3.5 h
    Infiltration: 0.5-2 h
    Nerve block, minor: 1-2 h
    Epidural: 100 min
    Spinal: 0.5-2 h
    Duration of action: Combined with epinephrine*Infiltration: 3-4 h
    Nerve block, minor: 4-7 h
    Infiltration: 2 h
    Nerve block, minor: 2-3 h
    Maximum doseSingle injections up to 175 mg without epinephrine or 225 mg with epinephrine; may repeat up to once every 3 hours.
    Maximum dosage: 400 mg/24 hours.
    Maximum: 4.5 mg/kg/dose not to exceed 300 mg without epinephrine or 7mg/kg/dose not to exceed 500 mg with epinephrine; do not repeat within 2 hours.
    Maximum dose for spinal anesthesia is 100 mg.
    Protein Binding82%-96%60%-80%
    Volume of distribution~2.5 L/kg1.5 + 0.6 L/kg
    Half-life, terminalAdults: 1.5-5 h
    Neonates: 8.1 h
    Adults: 1.5-2 h
    Premature infants: 3.2 h
    MetabolismUndergoes N-dealkylation in the liver.Extensive hepatic metabolism (90%) with active metabolites.
    EliminationExcreted in urine as metabolites and 5% as unchanged drug. Excreted in urine as metabolites (90%) and unchanged drug (< 10 %).

References

    1. Berde CB, Strichartz GR. Local anesthetics. In: Miller RD, ed. Miller's Anesthesia. 8th ed. Philadelphia, PA: Elsevier Saunders;2015:1028-1054.e4.
    2. Drasner K. Local anesthetics. In: Miller RD, Pardo MC, ed. Basics of Anesthesia. 6th ed. Philadelphia, PA: Elsevier Saunders;2011:130-142.
    3. Drugdex system. Micromedex 2.0 [database online]. http://www.micromedexsolutions.com. Updated March 13, 2018. Greenwood Village, CO: Truven Health Analytics; Accessed March 13, 2018.
    4. Lexi-Drugs Online. Hudson, OH: Lexi-Comp, Inc; 2018.
    5. Lidocaine hydrochloride and epinephrine injection, solution [package insert]. Lake Forest, IL: Hospira Inc; 2017.
    6. McEvoy GK, Snow EK, Kester L, Litvak K, Miller J, Welsh OH, eds. AHFS DI (Lexi-Comp Online). Bethesda, MD: American Society of Health-System Pharmacists; 2018.

Updated

Updated November 21, 2022 by Michelle Wheeler, PharmD, Drug Information Specialist. Created June 23, 2015 by Jane Chandramouli, PharmD, Drug Information Specialist. © 2022, Drug Information Service, University of Utah, Salt Lake City, UT.

ADVERTISEMENT

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.

« Back to Drug Shortage Product Bulletins


ahfs logo

Subscribe to AHFS Clinical Drug Information to get direct access to integrated drug shortages content, plus comprehensive and actionable drug information.