Hydroxocobalamin Injection shortage
Hydroxocobalamin Injection is currently listed in shortage by the FDA. The FDA lists 2 affected products. The reported reason: Other. This page was last refreshed from FDA data on Oct 3, 2026.
Hydroxocobalamin injection (the 30 mL multi-dose vial) is in shortage, with no available source for that size right now; Teva estimates recovery by October 2026. The 5 g/250 mL strength remains available, and BTG International's Cyanokit is currently in stock and can be ordered.
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 Hydroxocobalamin Injection. Other makers that haven’t reported a problem are shown in the green card below.
Shortage timeline
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Oct 1, 2026Currently in shortage2 of 2 products affected.
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Nov 4, 2024First reported to the FDA2 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: BTG International Inc. 📞 1 877 377 3784 1 NDC click to expand
| Status | NDC / product | Strength / size | Availability | Related information | Reason |
|---|---|---|---|---|---|
| Current | Cyanokit, Injection, 5 g/250mL (NDC 50633-310-11) | — | Limited Availability | Cyanokit is available to order. To address the drug shortage, BTG International Inc (a SERB Pharmaceuticals company) coordinated with the U.S. Food and Drug Administration (FDA) to make the following impacted batches available to U.S. patients during this period of shortage. | Other |
Manufacturer: Teva Pharmaceuticals USA, Inc. 📞 800-545-8800 1 NDC click to expand
| Status | NDC / product | Strength / size | Availability | Related information | Reason |
|---|---|---|---|---|---|
| Current | Hydroxocobalamin, Injection, 1000 MCG/ML, 30 ML Multi-Dose Vial (NDC 0591-2888-30) | — | Unavailable | Estimated recovery: October 2026 | Other |
These rows are manufacturer reports to the FDA for Hydroxocobalamin 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 Hydroxocobalamin Injection? options further down this page.
Why is Hydroxocobalamin Injection in shortage?
Right now, there are supply challenges with hydroxocobalamin injection from two manufacturers, and the FDA has listed the reason as "Other" for both — meaning neither company shared a more specific public explanation for why the shortage is happening. What we do know is this: Teva Pharmaceuticals' 1,000 mcg/mL, 30 mL multi-dose vial is currently unavailable, and they estimate it won't be back in supply until October 2026.
For BTG International's product — Cyanokit (5 g/250 mL) — the situation is a little different. It has limited availability, but BTG worked directly with the FDA to release certain affected batches so patients in the U.S. could still access it during this shortage period, and it is currently available to order. Again, the specific underlying cause wasn't publicly disclosed by either company.
Based on the manufacturer-reported reason(s) and notes on file with the FDA for Hydroxocobalamin 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 Hydroxocobalamin Injection?
Hydroxocobalamin Injection is currently on the FDA drug-shortage list. This affects the two forms differently, so the first step is to find the one you take.
The 30 mL multi-dose vial (1000 mcg/mL) from Teva currently has no available source, with an estimated recovery of October 2026. The 5 g/250 mL form (Cyanokit) from BTG International is still being supplied, though in limited availability. In short, one of the two listed strengths still has a source. The reported reason is listed only as "Other," and this shortage has been ongoing for over a year.
Please keep in mind that this information comes from national, manufacturer-reported FDA data and may not match what your local pharmacy actually has on its shelves.
Here is what I suggest:
- Do not stop, skip, or change your dose on your own.
- If you use the 5 g/250 mL form, ask your pharmacy to order it, since it remains available; pharmacies can check wholesalers and other suppliers.
- If you use the 30 mL vial, talk with your prescriber or pharmacist about options while supply recovers.
- Manufacturer contact numbers are listed on this page for reference, though pharmacies usually handle these calls.
I'm here if you have questions.
- 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.
Where else can I get Hydroxocobalamin 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 Hydroxocobalamin 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.
Alternative dosage forms of Hydroxocobalamin
A different form of the same drug (for example a solution when capsules are short). A form change is a clinical decision — ask your prescriber:
Therapeutic equivalents & pricing 2 productsclick to expand
Orange Book–rated equivalents of the affected strengths / sizes, 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 |
|---|---|---|---|---|---|
| Hydroxocobalamin 1000 ug/mL | Actavis | 1 vial | $0.814 | — | Availability likely |
| Cyanokit 5 g/250mL | BTG | 1 vial | — | — | 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 Hydroxocobalamin Injection — that fall in the same broad treatment class (antidotes,miscellaneous) . 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 other shortages
Hydroxocobalamin Injection shortage FAQs
Is Hydroxocobalamin Injection in shortage?
Why is Hydroxocobalamin Injection in shortage?
Which products are affected?
When will Hydroxocobalamin Injection be available again?
Can I still get Hydroxocobalamin somewhere?
What should I do if I take Hydroxocobalamin Injection?
Still have a question about the Hydroxocobalamin Injection shortage?
Ask a pharmacist about this shortage →View Hydroxocobalamin Injection 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.