Ketamine Injection Shortage

• • 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

• • 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.

• • 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