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12/17/2024

Ketamine Injection

Products Affected - Description

    • Ketalar injection, Par Pharmaceuticals, 100 mg/mL, 5 mL vial, 10 count, NDC 42023-0115-10
    • Ketalar injection, Par Pharmaceuticals, 50 mg/mL, 10 mL vial, 10 count, NDC 42023-0114-10
    • Ketamine injection, Eugia US, 100 mg/mL, 10 mL vial, 10 count, NDC 55150-0440-10
    • Ketamine injection, Eugia US, 50 mg/mL, 10 mL vial, 10 count, NDC 55150-0439-10
    • Ketamine injection, Pfizer, 50 mg/mL, 10 mL vial, 10 count, NDC 00409-2053-10

Reason for the Shortage

    • AuroMedics (Eugia) has ketamine on shortage due to increased demand.
    • Hikma has ketamine injection available.
    • Mylan Institutional divested ketamine to AuroMedics.
    • Par has Ketalar on back order due to shortage of active ingredient.
    • Pfizer has ketamine on shortage due to manufacturing delays.
    • Sagent has ketamine injection available.

Available Products

    • Ketalar injection, Par Pharmaceuticals, 10 mg/mL, 20 mL vial, 10 count, NDC 42023-0113-10
    • Ketamine injection, Eugia US, 10 mg/mL, 20 mL vial, 10 count, NDC 55150-0438-10
    • Ketamine injection, Hikma, 100 mg/mL, 5 mL vial, 10 count, NDC 00143-9509-10
    • Ketamine injection, Hikma, 50 mg/mL, 10 mL vial, 10 count, NDC 00143-9508-10
    • Ketamine injection, Pfizer, 100 mg/mL, 5 mL vial, 10 count, NDC 00409-2051-05
    • Ketamine injection, Sagent, 10 mg/mL, 20 mL vial, 10 count, NDC 25021-0682-20
    • Ketamine injection, Sagent, 100 mg/mL, 5 mL vial, 10 count, NDC 25021-0684-05
    • Ketamine injection, Sagent, 50 mg/mL, 10 mL vial, 10 count, NDC 25021-0683-10

Estimated Resupply Dates

    • Eugia has ketamine 50 mg/mL 10 mL vials and 100 mg/mL 10 mL vials on intermittent back order and the company is releasing product as it becomes available.
    • Pfizer has ketamine 50 mg/mL 10 mL vials on back order and the company estimates a release date of December 2026.
    • Par has Ketalar 50 mg/mL 10 mL vials and 100 mg/mL 5 mL vial on back order and the company cannot estimate a release date.

Implications for Patient Care

    • Ketamine is an injectable anesthetic used for the induction of general anesthesia as well as supplementation to other anesthetic agents. It is also used as a single anesthetic agent for procedures that do not require relaxation of skeletal muscles.[1]

Safety

    • Ketamine is beneficial in its hemodynamic stability; when considering alternatives, it is important to be aware of possible changes to hemodynamics.[2]

Alternative Agents & Management

    • Etomidate and propofol are common alternatives for ketamine. 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. Ketamine hydrochloride [prescribing information]. Lake Forest, IL: Hospira Inc; July 2022.
    2. 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 December 17, 2024 by Michelle Wheeler, PharmD, Drug Information Specialist. Created February 7, 2018 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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