Reason for the Shortage

• • Baxter had sterile water for irrigation on shortage due manufacturing delays.[1]
  • BBraun has sterile water for irrigation available.[2]
  • Hospira has sterile water for irrigation available.[3]

Available Products

• • Sterile Water for Irrigation, BBraun, 1000 mL bottle, 16 count, NDC 00264-2101-00
  • Sterile Water for Irrigation, BBraun, 2000 mL bag, 4 count, NDC 00264-7386-50
  • Sterile Water for Irrigation, BBraun, 2000 mL bottle, 8 count, NDC 00264-2101-50
  • Sterile Water for Irrigation, BBraun, 3000 mL bag, 4 count, NDC 00264-7386-60
  • Sterile Water for Irrigation, BBraun, 4000 mL bottle, 4 count, NDC 00264-2101-70
  • Sterile Water for Irrigation, BBraun, 500 mL bottle, 16 count, NDC 00264-2101-10
  • Sterile Water for Irrigation, Baxter, 1000 mL bag, 14 count, NDC 00338-0003-44
  • Sterile Water for Irrigation, Baxter, 1000 mL bottle, 12 count, NDC 00338-0004-04
  • Sterile Water for Irrigation, Baxter, 1500 mL bottle, 9 count, NDC 00338-0004-05
  • Sterile Water for Irrigation, Baxter, 2000 mL bag, 6 count, NDC 00338-0003-46
  • Sterile Water for Irrigation, Baxter, 250 mL bottle, 24 count, NDC 00338-0004-02
  • Sterile Water for Irrigation, Baxter, 3000 mL bag, 4 count, NDC 00338-0003-47
  • Sterile Water for Irrigation, Baxter, 500 mL bottle, 18 count, NDC 00338-0004-03
  • Sterile Water for Irrigation, Pfizer, 1000 mL bag, 12 count, NDC 00409-7973-05
  • Sterile Water for Irrigation, Pfizer, 1000 mL bottle, 12 count, NDC 00409-7139-09
  • Sterile Water for Irrigation, Pfizer, 1500 mL bottle, 9 count, NDC 00409-7139-36
  • Sterile Water for Irrigation, Pfizer, 2000 mL bag, 6 count, NDC 00409-7973-07
  • Sterile Water for Irrigation, Pfizer, 250 mL bottle, 24 count, NDC 00409-6139-22
  • Sterile Water for Irrigation, Pfizer, 3000 mL bag, 4 count, NDC 00409-7973-08
  • Sterile Water for Irrigation, Pfizer, 500 mL bottle, 24 count, NDC 00409-6139-03

• • Sterile Water for Irrigation is available from BBraun, Baxter and Hospira.[1,2,3]

• • Sterile water, lactated ringer's, sodium chloride, and irrigations are all widely used.[4]

• • Clinicians may need to utilize different product sizes or packaging if desired sizes are not available.
  • Multiple brands of products may be available in the system.

• • Make policies to allow substitution of products based on product availability at the site. For example, an organization could choose to allow lactated ringers solution to be substituted for sterile water. Table 1 provides a comparison of fluid components of other irrigation solutions besides sterile water.
  • Evaluate the clinical need for irrigation fluid replacement. Discontinue irrigations when appropriate.
  • Use smaller bag sizes when possible.
  • Consider reserving some products for specific clinical situations.

  Table 1. Comparison of Selected Irrigation Fluids5,6

  Product	mOsm/L	Na (mEq/L)	Cl (mEq/L)	Dextrose (g/L)	K (mEq/L)	Ca (mEq/L)	Lactate (mEq/L)
  Lactated Ringers Solution	274	130	109		4	3	28
  0.9% Sodium Chloride	308	154	154

  
  

• 1. Baxter (personal communications). August 14, November 7, 2014; January 28, March 9, April 15, May 18, July 6, September 30, and October 8, 2015.
  2. BBraun (personal communications). August 15, November 7, 2014; January 28, May 18, and September 23, 2015.
  3. Hospira (personal communications and website). August 15, November 7, December 2, 2014; January 28, March 9, May 4 and 18, July 14, September 30, and October 13, 2015.
  4. 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; 2014.
  5. Hospira. Lactated Ringer's Irrigation, USP [product information]. Lake Forest, IL: Hospira; 2009.
  6. Hospira. 0.45% Sodium Chloride Irrigation, USP, and 0.9% Sodium Chloride Irrigation, USP, [product information]. Lake Forest, IL: Hospira; 2009.