Epinephrine Bitartrate, Lidocaine Hydrochloride Injection shortage
Epinephrine Bitartrate, Lidocaine Hydrochloride Injection is currently listed in shortage by the FDA. The FDA lists 22 affected products. The reported reason: Other; Demand increase for the drug. This page was last refreshed from FDA data on Sep 20, 2026.
Some strengths of the lidocaine with epinephrine injection are currently hard to get, with six specific concentrations having no available source right now due to manufacturing delays and rising demand. Several other strengths are still listed as available from multiple manufacturers, including Xylocaine brand.
Don’t stop or change your therapy on your own — ask your pharmacist about other manufacturers (see options) and your prescriber about a long-term plan.
Do you take this drug? See the ‘What to do’ recommendation from Dr. Brian Staiger, PharmD →What’s in shortage — at a glance
These figures count only the manufacturers that reported this shortage to the FDA — not every company that makes Epinephrine Bitartrate, Lidocaine Hydrochloride Injection. Other makers that haven’t reported a problem are shown in the green card below.
Shortage timeline
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Sep 15, 2026Currently in shortage22 of 22 products affected.
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Sep 9, 2026FDA refreshed this shortage record10 products updated.
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Oct 14, 2016More presentations reported12 more products added to the shortage.
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Feb 22, 2012First reported to the FDA10 products first listed.
Built from FDA posting and update dates. The end date FDA publishes is the posting/update date, not a true resolution date, so durations are approximate.
What exactly is on backorder — by manufacturer
Manufacturer: Fresenius Kabi USA, LLC 📞 888-386-1300 12 NDCS click to expand
| Status | NDC / product | Strength | Availability | Related information | Reason |
|---|---|---|---|---|---|
| Current | Xylocaine, Injection, .005 mg/1 mL; 15 mg/1 mL (NDC 63323-488-37) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .005 mg/1 mL; 10 mg/1 mL (NDC 63323-487-17) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .01 mg/1 mL; 20 mg/1 mL (NDC 63323-483-27) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .01 mg/1 mL; 10 mg/1 mL (NDC 63323-482-27) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .01 mg/1 mL; 10 mg/1 mL (NDC 63323-482-57) | — | Unavailable | Next release September 2026. Check wholesalers for inventory. | Other |
| Current | Xylocaine, Injection, .005 mg/1 mL; 20 mg/1 mL (NDC 63323-489-17) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .01 mg/1 mL; 10 mg/1 mL (NDC 63323-482-17) | — | Available | Check wholesalers for inventory | Demand increase for the drug |
| Current | Xylocaine, Injection, .01 mg/1 mL; 20 mg/1 mL (NDC 63323-483-57) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .005 mg/1 mL; 10 mg/1 mL (NDC 63323-487-37) | — | Available | Check wholesalers for inventory | — |
| Current | Xylocaine, Injection, .005 mg/1 mL; 5 mg/1 mL (NDC 63323-481-57) | — | Unavailable | Next release September 2026. Check wholesalers for inventory. | Demand increase for the drug |
| Current | Xylocaine, Injection, .005 mg/1 mL; 20 mg/1 mL (NDC 63323-489-27) | — | Unavailable | Next release September 2026. Check wholesalers for inventory. | Other |
| Current | Xylocaine, Injection, .005 mg/1 mL; 15 mg/1 mL (NDC 63323-488-17) | — | Unavailable | Next release September 2026. Check wholesalers for inventory. | Demand increase for the drug |
Manufacturer: Hospira, Inc., a Pfizer Company 📞 844-646-4398 10 NDCS click to expand
| Status | NDC / product | Strength | Availability | Related information | Reason |
|---|---|---|---|---|---|
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 1 g/50 mL (2%; 1:100,000) (NDC 0409-3182-03) | — | Limited Availability | Limited Supply Available. Next Delivery: May 2027; Estimated Recovery: June 2027; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 450 mg/30 mL (1.5%; 1:200,000) (NDC 0409-3181-01) | — | Available | — | — |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 400 mg/20 mL (2%; 1:100,000) (NDC 0409-3182-01) | — | Unavailable | Next Delivery and Estimated Recovery: December 2028; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride and Epinephrine, Injection, 600 mg/30 mL (2%; 1:100,000) (NDC 0409-3182-02) | — | Limited Availability | Limited Supply Available. Next Delivery: May 2027; Estimated Recovery: June 2027; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 500 mg/50 mL (1%; 1:100,000) (NDC 0409-3178-03) | — | Available | — | — |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 200 mg/20 mL (1%; 1:100,000) (NDC 0409-3178-01) | — | Unavailable | Next Delivery: October 2026; Estimated Recovery: December 2026; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 75 mg/5 mL (1.5%; 1:200,000) (NDC 0409-1209-01) | — | Unavailable | Next Delivery: November 2026; Estimated Recovery: December 2026; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 400 mg/20 mL (2%; 1:200,000) (NDC 0409-3183-01) | — | Available | — | — |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 300 mg/30 mL (1%; 1:100,000) (NDC 0409-3178-02) | — | Unavailable | Next Delivery: November 2026; Estimated Recovery: December 2026; Shortage per Manufacturer: Manufacturing Delay | Other |
| Current | Lidocaine Hydrochloride And Epinephrine, Injection, 2.5 g/50 mL (0.5%; 1:200,000) (NDC 0409-3177-01) | — | Unavailable | Next Delivery: November 2026; Estimated Recovery: December 2026; Shortage per Manufacturer: Manufacturing Delay | Other |
These rows are manufacturer reports to the FDA for Epinephrine Bitartrate, Lidocaine Hydrochloride Injection — they do not necessarily cover every manufacturer that makes this drug. A company appears here only if it told the FDA it has a supply problem, so other makers may still have stock. That’s the basis for the Where else can I get Epinephrine Bitartrate, Lidocaine Hydrochloride Injection? options further down this page.
Why is Epinephrine Bitartrate, Lidocaine Hydrochloride Injection in shortage?
There are two manufacturers reporting shortages of this combination lidocaine/epinephrine injection, and the reasons are a little different for each. For Fresenius Kabi, the main driver is that more people need this medication than usual (increased demand), and that has outpaced their supply. Three of their Xylocaine strengths — the 5 mg/mL, 15 mg/mL, and 20 mg/mL (with 0.005 mg/mL epinephrine) versions, plus the 10 mg/mL (with 0.01 mg/mL epinephrine) package — are currently unavailable, with the next release expected in September 2026. Importantly, several other Fresenius Kabi strengths and package sizes are still available.
For Hospira (Pfizer), the cause is a hold-up at the factory (a manufacturing delay). Several of their strengths are currently unavailable — including the 200 mg/20 mL (1%; 1:100,000), with a next delivery expected as early as October 2026 and estimated recovery by December 2026; the 2.5 g/50 mL, 300 mg/30 mL, and 75 mg/5 mL versions, expected to arrive November 2026 with recovery by December 2026; and the 400 mg/20 mL (2%; 1:100,000), which has a much longer timeline with next delivery and recovery not expected until December 2028. Their 600 mg/30 mL (2%; 1:100,000) has only limited supply available, with the next delivery not expected until May 2027. Their 400 mg/20 mL (2%; 1:200,000) and 500 mg/50 mL (1%; 1:100,000) strengths are currently still available.
Based on the manufacturer-reported reason(s) and notes on file with the FDA for Epinephrine Bitartrate, Lidocaine Hydrochloride Injection, summarized in plain English by HelloPharmacist. A drug can be short for more than one reason, and the FDA updates these as manufacturers report changes.
What should I do if I take Epinephrine Bitartrate, Lidocaine Hydrochloride Injection?
Lidocaine with epinephrine injection (also sold under the name Xylocaine) is currently on the FDA shortage list. This is a combination medicine used mainly for numbing during procedures, and both manufacturers who filed this report still have some strengths available.
Several strengths remain in supply, including the 1% (500 mg/50 mL) and 2% (400 mg/20 mL) concentrations, along with several Xylocaine strengths such as the 10 mg/mL products. The strengths reported with no available source right now include the 0.5% (2.5 g/50 mL), the 1% (300 mg/30 mL and 200 mg/20 mL), the 1.5% (75 mg/5 mL), the 2% (400 mg/20 mL at 1:100,000), and a few smaller Xylocaine vials.
The reasons given are increased demand and manufacturing delays. This shortage has lasted more than a year, and some restocking dates run into 2026, with one product noted as far out as 2028. Because this is a professionally administered injection, your care team manages sourcing on your behalf.
What you can do:
- Do not skip or change any planned treatment on your own — talk with your clinician first.
- Ask your pharmacy or provider to check wholesalers, since two manufacturers still list available strengths.
- If your exact strength is unavailable, ask your prescriber about a suitable alternative concentration or product.
Manufacturer contact numbers are listed on this page for reference. This reflects national data and may not match local stock.
- Don’t stop or change the medication on your own — talk to your prescriber first.
- If this is part of an ongoing or essential regimen (for example HIV treatment or prevention, seizure, heart, transplant, diabetes or mental-health medicines), do not skip or ration doses — contact your pharmacist or prescriber right away to arrange continued supply before you run out.
- Ask your pharmacy to check other manufacturers, strengths, package sizes, and nearby stores.
- Ask your prescriber whether a different strength, formulation, or the brand/generic version is appropriate.
Uses, dosing, side effects, prices, and the complete FDA label — written in plain English and pharmacist-reviewed.
Where else can I get Epinephrine Bitartrate, Lidocaine Hydrochloride Injection?
FDA shortages are manufacturer-reported — a company only shows up on the shortage list if it told the FDA it has a supply problem, so not every maker of Epinephrine Bitartrate, Lidocaine Hydrochloride Injection is necessarily short. Below we pull together the other still-marketed options that are not reported in shortage: the same medicine from manufacturers that haven’t reported a problem, and alternative dosage forms. These may still be out of stock at your pharmacy, and only your prescriber or pharmacist can decide what’s right for you.
Same medicine, other manufacturers (not reported short)
Same active ingredient, dosage form & route as the shortage (matched on the FDB HICL ingredient code), from makers that have not filed a shortage with the FDA:
| Product | Strength | Form / route | Manufacturer | NDC |
|---|---|---|---|---|
| Lidocaine Hydrochloride And Epinephrine | LIDOCAINE HYDROCHLORIDE 10 mg/mL; EPINEPHRINE 10 ug/mL | Injection, Solution · Infiltration, Perineural | Hospira, Inc. | 00409-0007-10 |
| Lidocaine Hydrochloride And Epinephrine | LIDOCAINE HYDROCHLORIDE 20 mg/mL; EPINEPHRINE 10 ug/mL | Injection, Solution · Infiltration, Perineural | Hospira, Inc. | 00409-0147-10 |
| Lidocaine Hydrochloride And Epinephrine | LIDOCAINE HYDROCHLORIDE 15 mg/mL; EPINEPHRINE 5 ug/mL | Injection, Solution · Epidural | Hospira, Inc. | 00409-1209-05 |
| Xylocaine | LIDOCAINE HYDROCHLORIDE ANHYDROUS 20 mg/mL; EPINEPHRINE BITARTRATE .01 mg/mL | Injection, Solution · Infiltration, Perineural | A-S Medication Solutions | 50090-6851-00 |
| Xylocaine | LIDOCAINE HYDROCHLORIDE ANHYDROUS 10 mg/mL; EPINEPHRINE BITARTRATE .01 mg/mL | Injection, Solution · Infiltration, Perineural | Fresenius Kabi USA, LLC | 63323-0482-26 |
| Xylocaine Mpf | LIDOCAINE HYDROCHLORIDE ANHYDROUS 10 mg/mL; EPINEPHRINE BITARTRATE .005 mg/mL | Injection, Solution · Epidural, Infiltration, Intracaudal, Perineural | Fresenius Kabi USA, LLC | 63323-0487-31 |
| Xylocaine Mpf | LIDOCAINE HYDROCHLORIDE ANHYDROUS 15 mg/mL; EPINEPHRINE BITARTRATE .005 mg/mL | Injection, Solution · Epidural, Infiltration, Intracaudal, Perineural | Fresenius Kabi USA, LLC | 63323-0488-31 |
| Xylocaine Mpf | LIDOCAINE HYDROCHLORIDE ANHYDROUS 20 mg/mL; EPINEPHRINE BITARTRATE .005 mg/mL | Injection, Solution · Epidural, Infiltration, Intracaudal, Perineural | Fresenius Kabi USA, LLC | 63323-0489-21 |
| Xylocaine | LIDOCAINE HYDROCHLORIDE ANHYDROUS 10 mg/mL; EPINEPHRINE BITARTRATE .01 mg/mL | Injection, Solution · Infiltration, Perineural | REMEDYREPACK INC. | 70518-4152-01 |
Therapeutic equivalents & pricing 14 productsclick to expand
Orange Book–rated equivalents of the affected strengths, with the latest NADAC price (a federal retail-acquisition benchmark, not your copay) and an evidence-based availability label. Cheapest first.
| Product | Manufacturer | Package | NADAC $/unit | AB rating | Availability |
|---|---|---|---|---|---|
| Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL | Hospira, | 25 vials | $0.134 | — | FDA listed |
| Xylocaine 20 mg/mL; .01 mg/mL | Fresenius | 25 vials | $0.265 | AP | FDA listed |
| Xylocaine MPF 15 mg/mL; .005 mg/mL | Fresenius | 25 vials | — | AP | FDA listed |
| Xylocaine MPF 10 mg/mL; .005 mg/mL | Fresenius | 25 vials | — | AP | FDA listed |
| Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL | Henry | 1 vial | — | — | FDA listed |
| Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL | Henry | 1 vial | — | — | FDA listed |
| Xylocaine 20 mg/mL; .01 mg/mL | Henry | 1 vial | — | AP | FDA listed |
| Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL | Hospira, | 10 vials | — | — | FDA listed |
| Xylocaine 20 mg/mL; .01 mg/mL | A-S | 25 vials | — | AP | FDA listed |
| LIDOCAINE HCl AND EPINEPHRINE 20 mg/mL; 10 ug/mL | HF | 30 ml | — | — | FDA listed |
| LIDOCAINE HCl AND EPINEPHRINE 10 ug/mL; 20 mg/mL | HF | 50 ml | — | — | FDA listed |
| Lidocaine Hci And Epinephrine 20 mg/mL; .01 mg/mL | HF | 50 ml | — | AP | FDA listed |
| Lidocaine Hci And Epinephrine 20 mg/mL; .01 mg/mL | HF | 20 ml | — | AP | FDA listed |
| Lidocaine Hydrochloride and Epinephrine 20 mg/mL; 10 ug/mL | ProPharma | 50 ml | — | — | FDA listed |
Equivalents share the same ingredient, strength, dosage form and route; an AB rating means the FDA considers them substitutable. NADAC is a national retail-pharmacy acquisition benchmark from CMS — not what you pay. Availability is inferred from recent pricing, not a stock check.
Other drugs in the same treatment class
These are different medicines — not other versions of Epinephrine Bitartrate, Lidocaine Hydrochloride Injection — that fall in the same broad treatment class (local anesthetics) . They are not automatic substitutes: they can differ in how they work, dosing, effectiveness, side effects and what they’re approved to treat. Do not switch on your own. This list is for information only — ask your prescriber or pharmacist whether any of them is appropriate for you.
Identity & classification
Where does this data come from?
Other anesthesia, pediatric shortages
Epinephrine Bitartrate, Lidocaine Hydrochloride Injection shortage FAQs
Is Epinephrine Bitartrate, Lidocaine Hydrochloride Injection in shortage?
Why is Epinephrine Bitartrate, Lidocaine Hydrochloride Injection in shortage?
Which products are affected?
When will Epinephrine Bitartrate, Lidocaine Hydrochloride Injection be available again?
Can I still get Epinephrine Bitartrate, Lidocaine Hydrochloride somewhere?
What should I do if I take Epinephrine Bitartrate, Lidocaine Hydrochloride Injection?
Still have a question about the Epinephrine Bitartrate, Lidocaine Hydrochloride Injection shortage?
Ask a pharmacist about this shortage →View Epinephrine Bitartrate, Lidocaine Hydroc... on the FDA drug-shortage database →
Where does this data come from?
/drug/shortages) — drug, manufacturer & contact, NDC/product, status, availability, reason, therapeutic category and posting/update dates. Current / To Be Discontinued = active; Resolved is kept for history. The Supply-Risk rating is assessed per active ingredient and adds the FDA NDC Directory (still-marketed manufacturers by ingredient & form); same-medicine and equivalent products use First Databank classification + CMS NADAC pricing; Medicaid use + most-affected states come from CMS Medicaid State Drug Utilization Data. Reference only — confirm current status with the manufacturer or FDA before acting on it.