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Streptozocin For Injection

Last Updated: August 9, 2011
Status: Resolved

Products Affected - Description

Zanosar for injection, Teva

Reason for the Shortage

  • Teva had their Zanosar on shortage due to manufacturing delays.1
  • There are no other manufacturers of streptozocin injection.

Estimated Resupply Dates

Teva has available Zanosar for injection 1 gram (NDC 00703-4636-01) vials.1

Implications for Patient Care

  • Streptozocin is an antineoplastic antibiotic. It is labeled for use as a single agent or in combination with other antineoplastic agents for the treatment of symptomatic or progressive metastatic islet cell carcinoma of the pancreas.2-4
  • Streptozocin is used off-label for a variety of neoplastic diseases including Hodgkin disease, palliative treatment of metastatic carcinoid tumor, pancreatic adenocarcinoma, metastatic pheochromocytoma, and palliative treatment of colorectal cancer.2-4


  • Chemotherapy agents, such as streptozocin, pose additional safety risks both for patients and for healthcare workers handling these agents.2,3
  • Use additional caution when processing orders for chemotherapy drugs, especially when switching between chemotherapy agents or when processing orders for chemotherapy agents with which staff may be unfamiliar (eg, those not normally prescribed at a specific institution).2,3

Alternative Agents & Management

  • The choice of an alternative agent must be patient-specific and based on renal function, liver function, and the neoplasm type and location. No single agent can be substituted for streptozocin.2-4
  • Consider evaluating the health-care system’s total supply of streptozocin before beginning patients on combination chemotherapy regimens containing streptozocin. If adequate supplies are not available, select an alternative regimen.
  • Consult a Hematology/Oncology specialist for patient- and neoplasm-specific recommendations.
  • Refer to the ASHP Guidelines on Managing Drug Product Shortages for more guidance on developing a multidisciplinary plan when the supply must be allocated. 

Related Shortages


  1. Teva (personal communications). May 13, June 30, and August 9, 2011.
  2. Beckwith MC, Tyler LS, eds. Cancer Chemotherapy Manual. St. Louis, MO: Wolters Kluwer Health Inc. 2010.
  3. Antineoplastic agents. In: McEvoy GK, ed. AHFS 2010 Drug Information. Bethesda, MD: American Society of Health-Systems Pharmacists; 2010: 902-1260.
  4. Drug Facts and Comparisons Online. St. Louis, MO: Wolters Kluwer Health Inc. September 2010.


Updated August 9, 2011 by Michelle Wheeler, Pharm.D., Drug Information Specialist, Drug Information Service. Created September 8, 2010, by Leslie Jensen, Pharm.D. and M. Christina Beckwith, Pharm.D., Drug Information Specialists. Copyright 2011, Drug Information Service, University of Utah, Salt Lake City, UT.