Between two types of local anesthetics, there are 132 in short supply and 13 available, according to the American Society of Health-System Pharmacists.
Here's how the shortages of bupivacaine and lidocaine break down:
- Twenty bupivacaine injections from Pfizer are back-ordered because of manufacturing delays, and resupply dates fall between January and June. The company also has 15 lidocaine injections on back order and three available.
- Fresenius Kabi has eight bupivacaine products in short supply through late January to early February because of high demand. Eighteen of its lidocaine injections are in shortage and two are available.
- Eugia US has eight bupivacaine solutions on back order until February because of a shortage of an active ingredient. Eleven lidocaine injections are in shortage and two are not.
- Hikma Pharmaceuticals reports six bupivacaine items on back order, and the drugmaker expects release dates to be before the end of its first quarter. The reason for the shortage is that "Hikma launched bupivacaine in November 2021," ASHP wrote Jan. 17. It also has four lidocaine products back-ordered, but there was no reason listed.
- Amphastar Pharmaceuticals has one lidocaine injection syringe on allocation.
To alleviate the bupivacaine shortage, the FDA is temporarily allowing Areva Pharmaceuticals to import four solutions of the local anesthetic manufactured in Italy.
Lidocaine, bupivacaine's shorter-lasting alternative, is seeing increased demand. Most companies making lidocaine products told ASHP they expect resupply dates to be in the next few weeks.
Lidocaine has a quicker onset but a shorter duration of action. The length of each drug's effects can be prolonged by epinephrine. Those are in shortage, as well:
- Nineteen bupivacaine with epinephrine injections are on back order, including 12 from Pfizer and seven from Fresenius Kabi. Both expect resupply dates in the next few weeks, and the latter has one product available.
- Twenty-two lidocaine with epinephrine injections are back-ordered, and Pfizer and Fresenius Kabi said they predict release dates between late January and June. Fresenius Kabi has 12 in shortage and one that is not.