Products Affected - Description

• • Marcaine solution for injection, Pfizer, 0.25%, 10 mL preservative-free vial, 10 count, NDC 00409-1559-10
  • Marcaine solution for injection, Pfizer, 0.25%, 50 mL multiple dose vial, 1 count, NDC 00409-1587-50
  • Marcaine solution for injection, Pfizer, 0.5%, 30 mL preservative-free vial, 10 count, NDC 00409-1560-29
  • Marcaine solution for injection, Pfizer, 0.75%, 10 mL preservative-free vial, 10 count, NDC 00409-1582-10
  • Bupivacaine solution for injection, Eugia US, 0.5%, 50 mL vial, 25 count, NDC 55150-0250-50
  • Bupivacaine solution for injection, Hikma, 0.25%, 10 mL preservative-free vial, 10 count, NDC 00143-9330-10
  • Bupivacaine solution for injection, Hikma, 0.5%, 50 mL vial, 10 count, NDC 00143-9329-10
  • Bupivacaine solution for injection, Hikma, 0.75%, 10 mL preservative-free vial, 10 count, NDC 00143-9332-10
  • Bupivacaine solution for injection, Hikma, 0.75%, 30 mL preservative-free vial, 10 count, NDC 00143-9335-10
  • Bupivacaine solution for injection, Pfizer, 0.5%, 50 mL multiple dose vial, 25 count, NDC 00409-1163-01
  • Marcaine injection, Pfizer, 0.75% in 8.25% dextrose, 15 mg/2 mL ampule, 10 count, NDC 00409-1761-10

Reason for the Shortage

• • Eugia did not provide a reason for the shortage.
  • Baxter discontinued 0.75% bupivacaine in 8.25% dextrose 2 mL ampules in early-2023.
  • Fresenius Kabi has Sensorcaine injection available.
  • Hikma did not provide a reason for the shortage.
  • Meitheal has bupivacaine injection available.
  • Pfizer states the shortage is due to manufacturing delays.
  • Somerset has bupivacaine injection available.
  • Xellia has bupivacaine injection available.

Available Products

• • Marcaine solution for injection, Pfizer, 0.25%, 30 mL preservative-free vial, 10 count, NDC 00409-1559-30
  • Marcaine solution for injection, Pfizer, 0.5%, 10 mL preservative-free vial, 10 count, NDC 00409-1560-10
  • Marcaine solution for injection, Pfizer, 0.5%, 10 mL preservative-free vial, 25 count, NDC 00409-5010-25
  • Marcaine solution for injection, Pfizer, 0.5%, 50 mL multiple dose vial, 25 count, NDC 00409-0525-25
  • Marcaine solution for injection, Pfizer, 0.75%, 30 mL preservative-free vial, 25 count, NDC 00409-2253-25
  • Sensorcaine solution for injection, Fresenius Kabi, 0.25%, 50 mL multiple dose vial, 25 count, NDC 63323-0465-57
  • Sensorcaine solution for injection, Fresenius Kabi, 0.5%, 50 mL multiple dose vial, 25 count, NDC 63323-0467-57
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.25%, 10 mL preservative-free vial, 25 count, NDC 63323-0464-17
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.25%, 30 mL preservative-free vial, 25 count, NDC 63323-0464-37
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.5%, 10 mL preservative-free vial, 25 count, NDC 63323-0466-17
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.5%, 30 mL preservative-free vial, 25 count, NDC 63323-0466-37
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.75%, 10 mL preservative-free vial, 25 count, NDC 63323-0472-17
  • Sensorcaine-MPF solution for injection, Fresenius Kabi, 0.75%, 30 mL preservative-free vial, 25 count, NDC 63323-0472-37
  • Bupivacaine solution for injection, Eugia US, 0.25%, 10 mL preservative-free vial, 25 count, NDC 55150-0167-10
  • Bupivacaine solution for injection, Eugia US, 0.25%, 30 mL preservative-free vial, 25 count, NDC 55150-0168-30
  • Bupivacaine solution for injection, Eugia US, 0.25%, 50 mL vial, 25 count, NDC 55150-0249-50
  • Bupivacaine solution for injection, Eugia US, 0.5%, 10 mL preservative-free vial, 25 count, NDC 55150-0169-10
  • Bupivacaine solution for injection, Eugia US, 0.5%, 30 mL preservative-free vial, 25 count, NDC 55150-0170-30
  • Bupivacaine solution for injection, Eugia US, 0.75%, 10 mL preservative-free vial, 25 count, NDC 55150-0171-10
  • Bupivacaine solution for injection, Eugia US, 0.75%, 30 mL preservative-free vial, 25 count, NDC 55150-0172-30
  • Bupivacaine solution for injection, Hikma, 0.25%, 30 mL preservative-free vial, 10 count, NDC 00143-9333-10
  • Bupivacaine solution for injection, Hikma, 0.25%, 50 mL vial, 10 count, NDC 00143-9328-10
  • Bupivacaine solution for injection, Hikma, 0.5%, 10 mL preservative-free vial, 10 count, NDC 00143-9331-10
  • Bupivacaine solution for injection, Hikma, 0.5%, 30 mL preservative-free vial, 10 count, NDC 00143-9334-10
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.25%, 10 mL multiple dose vial, 50 count, NDC 71288-0721-11
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.25%, 30 mL multiple dose vial, 50 count, NDC 71288-0722-32
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.25%, 50 mL multiple dose vial, 1 count, NDC 71288-0723-52
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.5%, 10 mL multiple dose vial, 50 count, NDC 71288-0724-11
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.5%, 30 mL multiple dose vial, 50 count, NDC 71288-0725-32
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.5%, 50 mL multiple dose vial, 1 count, NDC 71288-0726-52
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.75%, 10 mL multiple dose vial, 50 count, NDC 71288-0727-11
  • Bupivacaine solution for injection, Meitheal Pharmaceuticals, 0.75%, 30 mL multiple dose vial, 50 count, NDC 71288-0728-32
  • Bupivacaine solution for injection, Pfizer, 0.25%, 10 mL preservative-free vial, 25 count, NDC 00409-1159-01
  • Bupivacaine solution for injection, Pfizer, 0.25%, 30 mL preservative-free vial, 25 count, NDC 00409-1159-02
  • Bupivacaine solution for injection, Pfizer, 0.25%, 50 mL multiple dose vial, 25 count, NDC 00409-1160-01
  • Bupivacaine solution for injection, Pfizer, 0.5%, 10 mL preservative-free vial, 25 count, NDC 00409-1162-01
  • Bupivacaine solution for injection, Pfizer, 0.5%, 30 mL preservative-free vial, 25 count, NDC 00409-1162-02
  • Bupivacaine solution for injection, Pfizer, 0.75%, 10 mL preservative-free vial, 25 count, NDC 00409-1165-01
  • Bupivacaine solution for injection, Pfizer, 0.75%, 30 mL preservative-free vial, 25 count, NDC 00409-1165-02
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.25%, 50 mL vial, 1 count, NDC 70069-0752-01
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.25%, 50 mL vial, 10 count, NDC 70069-0752-10
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.25%, 50 mL vial, 25 count, NDC 70069-0752-25
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.5%, 50 mL vial, 1 count, NDC 70069-0753-01
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.5%, 50 mL vial, 10 count, NDC 70069-0753-10
  • Bupivacaine solution for injection, Somerset Therapeutics LLC, 0.5%, 50 mL vial, 25 count, NDC 70069-0753-25
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.25%, 10 mL preservative-free vial, 10 count, NDC 70594-0114-02
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.25%, 30 mL preservative-free vial, 1 count, NDC 70594-0115-01
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.25%, 50 mL multiple dose vial, 1 count, NDC 70594-0116-01
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.5%, 10 mL preservative-free vial, 10 count, NDC 70594-0117-02
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.5%, 30 mL preservative-free vial, 1 count, NDC 70594-0118-01
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.5%, 50 mL multiple dose vial, 1 count, NDC 70594-0119-01
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.75%, 10 mL preservative-free vial, 10 count, NDC 70594-0120-02
  • Bupivacaine solution for injection, Xellia Pharmaceuticals, 0.75%, 30 mL preservative-free vial, 1 count, NDC 70594-0121-01
  • Bupivacaine injection, Pfizer, 0.75% in 8.25% dextrose, 15 mg/2 mL ampule, 10 count, NDC 00409-3613-01

• • Eugia has 0.5% bupivacaine 50 mL vials on back order and the company cannot estimate a release date.
  • Hikma has 0.25% bupivacaine 10 mL preservative-free vials on back order and the company estimates a release date of early-April 2026. Short-dated product is available (May 2026). The 0.5% bupivacaine 50 mL vials are on back order and the company estimates a release date in late-May 2026. The 0.75% bupivacaine 10 mL and 30 mL preservative-free vials are short-dated with an expiration date of February 2027 for the 10 mL vials and January 2027 for the 30 mL vials.
  • Pfizer has 0.5% bupivacaine 50 mL vials in limited supply. Short dated product is available. The 0.75% bupivacaine in 8.25% dextrose 2 mL ampules is on back order and the company estimates a release date of June 2026.
  • Pfizer has 0.25% Marcaine 30 mL preservative-free vials and 50 mL vials on back order and the company estimates a release date of March 2026. The 0.25% Marcaine 10 mL preservative-free vials are on back order and the company estimates a release date in July 2026. The 0.5% Marcaine 30 mL preservative-free vials are on back order and the company estimates a release date of March 2026. The 0.75% Marcaine 10 mL preservative-free vials are on back order and the company estimates a release date in March 2026. The 0.75% Marcaine 30 mL preservative-free vials are on back order and the company cannot estimate a release date. Marcaine 0.75% in 8.25% dextrose 2 mL ampules are in limited supply and the company is releasing supplies weekly.

• • 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

  Property	Bupivacaine	Lidocaine
  * Duration of effect is prolonged by use of local anesthetics in combination with epinephrine, although mangitude of effect is not well-defined for all routes.
  Onset of Action	Infiltration: 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 Dose	Single 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 binding	82%-96%	60%-80%
  Volume of distribution	~2.5 L/kg	1.5 + 0.6 L/kg
  Half-life, terminal	Adults: 1.5-5 h Neonates: 8.1 h	Adults: 1.5-2 h Premature infants: 3.2 h
  Metabolism	Undergoes N-dealkylation in the liver.	Extensive hepatic metabolism (90%) with active metabolites.
  Elimination	Excreted in urine as metabolites and 5% as unchanged drug.	Excreted in urine as metabolites (90%) and unchanged drug (<10%).

  
  

• 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. Bupivacaine 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.