What is the emergency syringe shortage right now?
FDA's shortage data, queried Oct. 30, shows a split market. Status differs by drug, manufacturer and NDC. These statuses are reported by manufacturers and do not show wholesaler stock or fill rates.
- Dextrose 50% syringes: Hospira's Ansyr II syringe (00409-7517-16) is listed Unavailable, with next delivery in November 2026 and full recovery estimated for March 2027. The Amphastar/IMS syringe (76329-3302-01) is listed Limited, with no date given.
- Sodium bicarbonate 8.4% 50 mL syringe: the IMS syringe (76329-3352-01) is listed Limited and available on allocation.
- Sodium bicarbonate 8.4% vials: several NDCs are currently listed Available, while Hospira 00409-6625-35 is listed Unavailable, with next delivery and recovery estimated for June 2027.
- Lidocaine 2% syringes: Hospira 00409-1323-05 is listed Limited, with recovery estimated for March 2027. IMS 76329-3390-01 is listed Available.
- Atropine 1 mg/10 mL syringes: Hospira 00409-1630-10 is listed Limited, with recovery estimated for December 2026. The IMS and Medefil syringes are listed Available.
FDA's shortage data does not show earlier values, and no public source dates when these statuses began, so this update cannot say whether any of them is new or getting worse. We also found no 2026 hospital or EMS report of crash-cart shortfalls and no 2026 FDA temporary importation letter for these products. Those are search results, not confirmed negatives.
PRN has also seen increased requests for emergency syringes, including dextrose 50%, this summer.
Are these syringes discontinued, or just difficult to source?
The items FDA lists as Unavailable or Limited are difficult to source, not discontinued, but one older line has ended. Pfizer told customers in an August 2025 letter that it was exiting its ABBOJECT emergency syringe platform, and it issued a further no-longer-available notice in November 2025. Pfizer said the decision was not due to safety or efficacy issues, and it cited supply disruptions on the platform. That is background, not news. By the August letter's dates, the last non-recalled lots had expired by April 30, 2026, so FDA's To Be Discontinued rows for ABBOJECT should not be read as a live supply option.
The absence of an FDA listing does not prove normal supply. FDA's shortage data returns no current row for single-ingredient epinephrine syringes, yet Amphastar's 10-Q reports higher demand for its epinephrine prefilled syringe, which it attributes to other suppliers' shortages.
What is causing it?
The public record gives reason codes but little explanation. What is confirmed:
- Hospira items: FDA's notes give a manufacturing delay, per the manufacturer, on the dextrose, lidocaine 2%, atropine 1 mg/10 mL and bicarbonate 00409-6625-35 rows above. No public source explains what is behind that delay, and no plant, equipment or component issue has been publicly tied to it.
- Amphastar syringes: FDA lists demand increase as the reason for the dextrose and bicarbonate limits. Amphastar's 10-Q attributes higher dextrose and bicarbonate sales in the first half of 2026 to demand caused by other suppliers' shortages, and its first-quarter release says the same of dextrose.
- Backlog: Amphastar reported a backlog of about $4.2 million across various products as of June 30, mainly from competitor shortages and supplier constraints. It is not broken out by product.
What is inference: Amphastar does not name the suppliers. Reading Pfizer's gaps as part of that demand is our interpretation, not something either company has said.
Which products and presentations are affected?
For the 8.4% 50 mL bicarbonate syringe, FDA's NDC directory lists IMS and the Hospira ABBOJECT, which has a marketing end date of Nov. 30, 2026, plus repackagers. For the dextrose 50% 50 mL syringe, the directory lists Hospira and IMS plus repackagers. Directory listings do not prove a product is actively marketed.
| Product | NDC | Manufacturer | FDA-listed status (row date) | Reason in FDA record |
|---|---|---|---|---|
| Dextrose 50% 25 g/50 mL Ansyr II plastic syringe | 00409-7517-16 | Hospira / Pfizer | Unavailable. Next delivery November 2026; estimated recovery March 2027 (Oct. 27, 2026) | Manufacturing delay, per manufacturer |
| Dextrose 50% 25 g/50 mL syringe | 76329-3302-01 | Amphastar / IMS | Limited. No date listed (Oct. 16, 2026) | Demand increase |
| Dextrose 50% 25 g/50 mL vial | 00409-6648-02 | Hospira / Pfizer | Limited. Next delivery November 2026; estimated recovery December 2026 (Oct. 27, 2026) | Manufacturing delay, per manufacturer |
| Sodium bicarbonate 8.4% 50 mL syringe | 76329-3352-01 | Amphastar / IMS | Limited, available on allocation (Oct. 16, 2026) | Demand increase |
| Sodium bicarbonate 8.4% 50 mL vial | 00409-6625-14 | Hospira / Pfizer | Available (Oct. 21, 2026) | None listed |
| Sodium bicarbonate 8.4% 50 mL vial | 00409-6625-35 | Hospira / Pfizer | Unavailable. Next delivery and recovery June 2027 (Oct. 21, 2026) | Manufacturing delay, per manufacturer |
| Sodium bicarbonate 8.4% 50 mL vial | 63323-0089-50 | Fresenius Kabi | Available; FDA row says to check wholesalers for inventory (Oct. 15, 2026) | None listed |
| Sodium bicarbonate 8.4% 50 mL vial | 51754-5001-05 | Exela | Available (Oct. 15, 2026) | None listed |
| Sodium bicarbonate 8.4% 10 mL vial | 51754-5011-04 | Exela | Available (Oct. 15, 2026) | None listed |
| Sodium bicarbonate 8.4% 50 mL vial | 81298-7620-03 | Long Grove | Available (Oct. 16, 2026) | None listed |
| Lidocaine 2% 100 mg/5 mL plastic syringe | 00409-1323-05 | Hospira / Pfizer | Limited. Next delivery January 2027; estimated recovery March 2027 (Oct. 21, 2026) | Manufacturing delay, per manufacturer |
| Lidocaine 2% 5 mL syringe | 76329-3390-01 | Amphastar / IMS | Available (Oct. 16, 2026) | None listed |
| Lidocaine 1% syringe | 00409-9137-05 | Hospira / Pfizer | Available (Oct. 21, 2026) | None listed |
| Atropine 1 mg/10 mL plastic syringe | 00409-1630-10 | Hospira / Pfizer | Limited. Next delivery November 2026; estimated recovery December 2026 (Oct. 21, 2026) | Manufacturing delay, per manufacturer |
| Atropine 1 mg/10 mL syringe | 76329-3340-01 | Amphastar / IMS | Available (Oct. 16, 2026) | None listed |
| Atropine 1 mg/10 mL plastic syringe | 64253-0400-91 | Medefil | Available (Oct. 15, 2026) | None listed |
| Atropine 0.25 mg/5 mL syringe | 00409-9630-05 | Hospira / Pfizer | Available (Oct. 21, 2026) | None listed |
As-of note: flumazenil
ADA News reported on Oct. 1 that manufacturers were reporting flumazenil injection back orders, relaying a university drug information bulletin dated Sept. 21. FDA's shortage data lists no flumazenil rows. FDA's extended-use list shows Baxter 10 mL lots A0H0421A and A0H0523A extended to Jan. 31, 2027. Treat this as a snapshot; we could not confirm the current position. Separately, FDA's shortage data lists no racepinephrine rows and we found no 2026 shortage report, so its current status is undocumented.
Watch item: what does the FDA warning letter to the IMS plant mean?
This is separate from the status rows above. No public source links the letter to the dextrose or bicarbonate limits, and FDA lists demand as the reason for both.
- What FDA said. Warning letter 320-26-99, dated July 2, 2026, went to IMS's South El Monte, California plant after a December 2025 inspection. It cites inadequate contamination investigations and aseptic processing design and equipment problems, and asks for comprehensive design changes to aseptic lines and cleanrooms.
- What it names. The only product named is epinephrine lot EA038A5, which was also recalled in April 2026 for lack of sterility assurance. That lot expired in August 2026. The letter also reports more than 90 customer complaints without naming the products, and parts of it are redacted. It cannot be read as either covering or excluding dextrose, bicarbonate or lidocaine.
- What Amphastar says. Its 8-K says the letter does not order a stop to manufacturing or distribution and that IMS continues to supply from the plant. Its 10-Q says FDA told IMS in April 2026 that the plant would be classified Official Action Indicated. It also says IMS voluntarily suspended one unnamed product, which Amphastar describes as not at risk of shortage, in consultation with FDA's Drug Shortage Staff, to prioritize unnamed products that are. It warns that remediation could slow production and that further regulatory action is possible. That is company risk language, not a report that a slowdown has occurred.
Amphastar's latest quarterly figures run through June 30. We found no third-quarter results as of this update.
How is this affecting healthcare buyers and facilities?
- Thin syringe options for D50. The two manufacturers the directory lists for the 50 mL syringe are both constrained on FDA's rows, one Unavailable and one Limited.
- Allocation on bicarbonate syringes. Allocation terms are not public. A move from syringe to vial changes preparation workflow and crash-cart stocking, which makes it an operational question for pharmacy and medical leadership.
- Recovery dates that vary by NDC. Hospira's estimates run from December 2026 for the D50 vial and atropine syringe to March 2027 for the D50 and lidocaine 2% syringes, and June 2027 for one bicarbonate vial.
- Available is a snapshot. The IMS lidocaine 2% and atropine rows read Available as of Oct. 16. That is a dated status, not an assurance of what a facility can receive.
What should facilities do when supply is tight?
These are PRN's operational suggestions, not sourced guidance. Substitution and protocol decisions belong to clinical teams, medical directors and P&T committees.
- Audit crash-cart par levels by NDC. Match each drawer and kit to the exact NDC you buy, then check that NDC's current FDA row.
- Clean up ABBOJECT references. Replace discontinued ABBOJECT NDCs in purchasing files and cart documents.
- Ask suppliers about allocation directly. Confirm whether your facility has an allocation and how it is set.
- Check dating against FDA's extended-use list. FDA's list, current as of Oct. 20, shows Hospira dextrose 25% syringe lots LH7103, LH7106 and LH7108 with an extended date of Oct. 1, 2026, which has passed. Pfizer's March 2026 letter says that extension was approved to mitigate a shortage of the product.
- Give clinical teams the supply facts first. If they are reviewing other dextrose concentrations, pull the current status. FDA's dextrose rows show 12 of 13 dextrose 10% rows Available as of Oct. 15 to 19.
- Plan a contingency for IMS-sourced syringes. Document what your facility would do if IMS output changed, and recheck FDA's rows and Amphastar's next filing on a set schedule.
Where can buyers monitor supply information through PRN?
Start with PRN's drug shortage index and Drug Shortage News for market context, then use the product pages linked above to review a specific NDC. High-Demand Products and the FAQ cover adjacent pressure points and common questions.
PRN can help facilities source these items and plan around them.
Need help planning around D50, bicarbonate, lidocaine or atropine syringe constraints? Request a Custom Quote for shortage-related sourcing support by NDC, or start customer onboarding if your facility needs a purchasing account.
Important note: This article is intended for general informational and procurement reference only. It is not medical, legal, or regulatory advice. Facilities should confirm current shortage status, lot dating, labeling, concentration, presentation, and purchasing decisions through current manufacturer, distributor, FDA, pharmacy, and institutional review channels before acting.