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Lidocaine Injection

Last Updated: January 18, 2023
Status: Current

Products Affected - Description
    • Xylocaine injection, Fresenius Kabi, 1%, 20 mL vial, 25 count, NDC 63323-0485-27
    • Xylocaine injection, Fresenius Kabi, 1%, 50 mL vial, 25 count, NDC 63323-0485-57
    • Xylocaine injection, Fresenius Kabi, 2%, 10 mL vial, 25 count, NDC 63323-0486-17
    • Xylocaine injection, Fresenius Kabi, 2%, 20 mL vial, 25 count, NDC 63323-0486-27
    • Xylocaine injection, Fresenius Kabi, 2%, 50 mL vial, 25 count, NDC 63323-0486-57
    • Xylocaine-MPF injection, Fresenius Kabi, 0.5%, 50 mL vial, 25 count, NDC 63323-0491-57
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 10 mL sterile-pack ampule, 5 count, NDC 63323-0492-97
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 2 mL vial, 25 count, NDC 63323-0492-27
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 30 mL vial, 25 count, NDC 63323-0492-37
    • Xylocaine-MPF injection, Fresenius Kabi, 1%, 5 mL vial, 25 count, NDC 63323-0492-57
    • Xylocaine-MPF injection, Fresenius Kabi, 1.5%, 10 mL ampule, 5 count, NDC 63323-0493-97
    • Xylocaine-MPF injection, Fresenius Kabi, 1.5%, 20 mL ampule, 5 count, NDC 63323-0493-91
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 10 mL ampule, 5 count, NDC 63323-0496-97
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 2 mL vial, 25 count, NDC 63323-0495-27
    • Xylocaine-MPF injection, Fresenius Kabi, 2%, 5 mL vial, 25 count, NDC 63323-0495-07
    • Lidocaine Hydrochloride injection, Amphastar, 2%, 5 mL Luer-Jet Emergency syringe, 10 count, NDC 76329-3390-01
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 10 mL vial, 25 count, NDC 55150-0251-10
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 2 mL ampule, 10 count, NDC 55150-0158-72
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 2 mL vial, 10 count, NDC 55150-0161-02
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 20 mL vial, 25 count, NDC 55150-0252-20
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 5 mL ampule, 10 count, NDC 55150-0159-74
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 5 mL vial, 10 count, NDC 55150-0162-05
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 10 mL vial, 25 count, NDC 55150-0254-10
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 2 mL ampule, 10 count, NDC 55150-0160-72
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 20 mL vial, 25 count, NDC 55150-0255-20
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 5 mL vial, 10 count, NDC 55150-0165-05
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 50 mL vial, 25 count, NDC 55150-0256-50
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 1%, 10 mL vial, 25 count, NDC 63323-0201-10
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 2%, 2 mL vial, 25 count, NDC 63323-0202-02
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 2%, 5 mL Tear-top preservative-free vial, 25 count, NDC 63323-0208-05
    • Lidocaine Hydrochloride injection, Hikma, 1%, 5 mL preservative-free vial, 25 count, NDC 00143-9595-25
    • Lidocaine Hydrochloride injection, Hikma, 1%, 50 mL vial, 10 count, NDC 00143-9577-10
    • Lidocaine Hydrochloride injection, Hikma, 2%, 5 mL preservative-free vial, 25 count, NDC 00143-9594-25
    • Lidocaine Hydrochloride injection, Hikma, 2%, 50 mL vial, 10 count, NDC 00143-9575-10
    • Lidocaine Hydrochloride injection, Pfizer, 0.5%, 50 mL SD Tear Top preservative-free vial, 25 count, NDC 00409-4278-01
    • Lidocaine Hydrochloride injection, Pfizer, 0.5%, 50 mL SD Flip Top vial, 25 count, NDC 00409-4275-01
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 2 mL preservative-free glass ampule, 50 count, NDC 00409-4713-32
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 20 mL vial, 25 count, NDC 00409-4276-01
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 30 mL preservative-free vial, 25 count, NDC 00409-4279-02
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL emergency Ansyr syringe, 10 count, NDC 00409-9137-05
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL preservative-free glass ampule, 50 count, NDC 00409-4713-02
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 50 mL vial, 25 count, NDC 00409-4276-02
    • Lidocaine Hydrochloride injection, Pfizer, 1.5%, 20 mL preservative-free ampule, 25 count, NDC 00409-4776-01
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 10 mL preservative-free glass ampule, 25 count, NDC 00409-4282-02
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 20 mL vial, 25 count, NDC 00409-4277-01
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL emergency Ansyr syringe, 10 count, NDC 00409-1323-05
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL LifeShield syringe, 10 count, NDC 00409-4903-34
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 5 mL preservative-free vial, 10 count, NDC 00409-2066-05
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 50 mL vial, 25 count, NDC 00409-4277-02
Reason for the Shortage
    • Amphastar has lidocaine syringes on shortage due to increased demand.
    • Eugia has lidocaine on shortage due to increased demand.
    • Fresenius Kabi has lidocaine on shortage due to increased demand.
    • Pfizer has lidocaine presentations on shortage due to manufacturing delays and increased demand.
Available Products
    • Xylocaine injection, Fresenius Kabi, 0.5%, 50 mL vial, 25 count, NDC 63323-0484-57
    • Lidocaine Hydrochloride injection, Eugia US, 1%, 30 mL vial, 1 count, NDC 55150-0163-30
    • Lidocaine Hydrochloride injection, Eugia US, 2%, 2 mL vial, 10 count, NDC 55150-0164-02
    • Lidocaine Hydrochloride injection, Fresenius Kabi, 1%, 2 mL vial, 25 count, NDC 63323-0201-02
    • Lidocaine Hydrochloride injection, Pfizer, 1%, 5 mL LifeShield syringe, 10 count, NDC 00409-4904-34
    • Lidocaine Hydrochloride injection, Pfizer, 2%, 2 mL preservative-free glass ampule, 25 count, NDC 00409-4282-01
    • Lidocaine Hydrochloride injection, Pfizer, 4%, 5 mL preservative-free glass ampule, 25 count, NDC 00409-4283-01

Estimated Resupply Dates

    • Amphastar has 2% lidocaine 5 mL syringes on allocation.
    • Eugia has 1 % lidocaine 2 mL ampules, 5 mL ampules, 2 mL vials, and 20 mL vials on back order and the company cannot estimate a release date. The 1% lidocaine 5 mL and 10 mL vials are on back order and the company estimates a release date of late-January 2023. The 2% lidocaine 2 mL ampules, 5 mL vials, and 50 mL vials are on back order and the company cannot estimate a release date. The 2% lidocaine 10 mL and 20 mL vials are on back order and the company estimates a release date of late-January 2023 for the 10 mL vials and mid-January 2023 for the 20 mL vials.
    • Fresenius Kabi has 0.5% Xylocaine-MPF 50 mL vials on back order and the company estimates a release date of late-January 2023. The 1% lidocaine 10 mL vials are on back order and the company estimates a release date of late-January to early-February 2023. The 1% Xylocaine 20 mL and 50 mL vials are on back order and the company estimates a release date of mid-January 2023 for the 20 mL vials and late-January to early-February 2023 for the 50 mL vials. The 1% Xylocaine-MPF 2 mL vials, 5 mL vials, and 30 mL vials are on back order and the company estimates a release date of late-January 2023. The 1% Xylocaine-MPF 10 mL vials in sterile packs are on back order and the company cannot estimate a release date. The 1.5% Xylocaine-MPF 10 mL and 20 mL ampules are on back order and the company cannot estimate a release date. The 2% Xylocaine 10 mL, 20 mL, and 50 mL vials are on back order and the company estimates a release date of mid-February 2023 for the 10 mL, late-January to early-February 2023 for the 20 mL vials, and late-January 2023 for the 50 mL vials. The 2% Xylocaine-MPF 2 mL and 5 mL vials are on back order and the company estimates a release date of late-January 2023 for the 2 mL vials and mid-January 2023 for the 5 mL vials. The 2% Xylocaine-MPF 10 mL ampules are on back order and the company cannot estimate a release date. The 2% lidocaine 2 mL and 5 mL vials are on back order and the company estimates a release date of late-January to early-February 2023 for the 2 mL vials and mid-February 2023 for the 5 mL vials.
    • Hikma has the 1% lidocaine 5 mL and 50 mL vials on back order and the company estimates a release date of mid-January 2023 for the 5 mL vials and late-March to early-April 2023 for the 50 mL vials. The 2% lidocaine 5 mL and 50 mL vials are on back order and the company estimates a release date of mid-January 2023.
    • Pfizer has 0.5% lidocaine 50 mL flip top vials on back order and the company estimates a release date of December 2023. The 0.5% lidocaine 50 mL tear top vials are on back order and the company estimates a release date of March 2023. The 1% lidocaine 20 mL and 50 mL vials are on back order and the company estimates a release date of February 2023 for the 20 mL vials and May 2023 for the 50 mL vials. The 1% lidocaine 30 mL preservative-free vials are on back order and the company estimates a release date of April 2023. The 1% lidocaine 2 mL and 5 mL ampules are available in limited supply. The 1% lidocaine 5 mL Ansyr syringes are on back order and the company estimates a release date of January 2023. The 1.5% lidocaine 20 mL ampules are on back order and the company estimates a release date of January 2023. The 2% lidocaine 10 mL ampules are on back order and the company estimates a release date of March 2023. The 2% lidocaine 5 mL, 20 mL, and 50 mL vials are on back order and the company estimates a release date of March 2023 for the 5 mL and 50 mL vials and January 2023 for the 20 mL vials. The 2% lidocaine 5 mL Ansyr syringes are on back order and the company estimates a release date of January 2023. The 2% lidocaine 5 mL LifeShield syringes are on back order and the company estimates a release date of January 2023.

Alternative Agents & Management

    • 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 magnitude 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 %).

References

    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. Lidocaine 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.

Updated

Updated January 18, 2023 by Michelle Wheeler, PharmD, Drug Information Specialist. Created June 23, 2015 by Jane Chandramouli, PharmD, Drug Information Specialist. © 2023, Drug Information Service, University of Utah, Salt Lake City, UT.

Further information

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