Labetalol Injection Shortage

• • Akorn did not provide a reason for the shortage.[1]
  • Alvogen did not provide a reason for the shortage.[2]
  • Fosun has labetalol injection available.[3]
  • Hikma had labetalol injection on shortage due to increase demand.[4]
  • Pfizer has labetalol injection available.[5]

• • Labetalol injection, Akorn, 5 mg/mL, 20 mL vial, 1 count, NDC 17478-0420-20
  • Labetalol injection, Akorn, 5 mg/mL, 40 mL vial, 1 count, NDC 17478-0420-40
  • Labetalol injection, Alvogen, 5 mg/mL, 20 mL vial, 1 count, NDC 47781-0586-29
  • Labetalol injection, Alvogen, 5 mg/mL, 40 mL vial, 1 count, NDC 47781-0586-56
  • Labetalol injection, Fosun Pharma, 5 mg/mL, 20 mL vial, 1 count, NDC 72266-0102-01
  • Labetalol injection, Fosun Pharma, 5 mg/mL, 40 mL vial, 1 count, NDC 72266-0103-01
  • Labetalol injection, Hikma, 5 mg/mL, 20 mL vial, 1 count, NDC 00143-9622-01
  • Labetalol injection, Hikma, 5 mg/mL, 40 mL vial, 1 count, NDC 00143-9623-01
  • Labetalol injection, Pfizer, 5 mg/mL, 20 mL vial, 1 count, NDC 00409-2267-20
  • Labetalol injection, Pfizer, 5 mg/mL, 4 mL Carpuject syringe, 10 count, NDC 00409-2339-34
  • Labetalol injection, Pfizer, 5 mg/mL, 40 mL vial, 1 count, NDC 00409-2267-54

Estimated Resupply Dates

• • All marketed presentations are available.

Implications for Patient Care

• • Labetalol is a nonselective beta-blocker with vascular alpha-receptor blocking ability. Intravenous labetalol is used in many populations as a first-line agent for the treatment of hypertensive emergency.[6-8]

Alternative Agents & Management

• • Use Carpuject syringes when possible to conserve labetalol vials for continuous infusions and large intermittent doses.
  • Intravenous labetalol is used a first-line agent in treating hypertensive emergency in pregnancy. Other appropriate options in treating hypertensive emergency in pregnant patients are intravenous hydralazine and oral nifedipine.[6-8]

References

• 1. Akorn. Personal communication. January 26, February 14, March 1 and 23, April 11, June 6, July 5, November 13,2017; February 26, August 7, September 25, November 2, December 26, 2018; March 12, April 12, August 12, October 1, November 6, 2019; February 19, April 2, July 7, and December 9, 2020.
  2. Alvogen. Personal communication. November 14, 2017; September 25, November 13, 2018; January 3, March 25, April 24, May 23, August 14, September 19, 2019; January 8, March 17, April 9, July 14, and September 14, 2020.
  3. Fosun Pharma. Personal communication. July 30, 2019.
  4. Hikma. Personal communication. March 24, June 7 and 29, July 14 and 19, August 24, September 7, November 9, December 14, 2017; January 18, February 7 and 28, April 18, May 16, August 8 and 29, September 26, October 17 and 31, November 14 and 28, December 20, 2018; January 9 and 30, March 13 and 20, April 10 and 24, June 5, July 10 and 31, August 14, September 4 and 18, October 30, November 27, 2019; January 2 and 22, February 19, March 12, April 1, 15, and 29, July 1 and 15, August 5, 12, and 19, and December 9, 2020.
  5. Pfizer. Personal communication. January 26, February 14, March 13, 22, and 28, April 21, May 3, June 2, July 6, 14, and 31, August 17 and 25, September 8, November 15, December 15, 2017; January 19, February 9, March 2, April 20, May 18, August 10 and 31, September 28, October 19, November 2, 13, and 30, 2018; January 8, February 1, March 15 and 25, April 12 and 30, June 5, July 9, August 2 and 13, September 17, November 4, December 3, 2019; January 7 and 24, February 20, March 13, April 2, 21, and 29, July 7 and 31, August 25, and December 4, 2020.
  6. Lexi-Drugs Online. Hudson, OH. Lexi-Comp, Inc.; 2017.
  7. Drugdex System (electronic version). Truven Health Analytics, Greenwood Village, CO. Available at http://www.micromedexsolutions.com (accessed March 13, 2017).
  8. Erstad, B, ed. Hypertenive Crisis and Drug Dosing in Special ICU populations. In:Critical Care Pharmacotherapy 2016. Lenexa, KS:American College of Clinical Pharmacy; 2016:763-832.