Dobutamine Injection Shortage

• • Dobutamine injection, Baxter, 1 mg/mL, 250 mL premixed bag, 12 count, NDC 00338-1073-02
  • Dobutamine injection, Baxter, 2 mg/mL, 250 mL premixed bag, 12 count, NDC 00338-1075-02
  • Dobutamine injection, Baxter, 4 mg/mL, 250 mL premixed bag, 12 count, NDC 00338-1077-02
  • Dobutamine injection, Hikma, 12.5 mg/mL, 20 mL vial, 10 count, NDC 00143-9141-10
  • Dobutamine injection, Pfizer, 1 mg/mL, 250 mL premixed bag, 12 count, NDC 00409-2346-32
  • Dobutamine injection, Pfizer, 2 mg/mL, 250 mL premixed bag, 12 count, NDC 00409-2347-32
  • Dobutamine injection, Pfizer, 4 mg/mL, 250 mL premixed bag, 12 count, NDC 00409-3724-32

• • Baxter has dobutamine premixed bags on a protective allocation for a potential increase in demand.
  • Hikma has dobutamine vials available.
  • Pfizer has dobutamine on shortage due to manufacturing delays.
  • Slate Run has dobutamine vials available.

• • Dobutamine injection, Pfizer, 12.5 mg/mL, 20 mL vial, 1 count, NDC 00409-2344-01
  • Dobutamine injection, Pfizer, 12.5 mg/mL, 20 mL vial, 10 count, NDC 00409-2344-02
  • Dobutamine injection, Slate Run Pharmaceuticals, 12.5 mg/mL, 20 mL vial, 10 count, NDC 70436-0203-82

Estimated Resupply Dates

• • Baxter has all dobutamine presentations on allocation.
  • Hikma has short-dated dobutamine 12.5 mg/mL 20 mL vials available with an expiration date of March 2025.
  • Pfizer has dobutamine 1 mg/mL 250 mL premixed bags on back order and the company estimates a release date of June 2024. The 2 mg/mL 250 mL premixed bags are on back order and the company estimates a release date of June 2024. The 4 mg/mL 250 mL premixed bags are on back order and the company estimates a release date of July 2024.

Implications for Patient Care

• • Dobutamine is a short-acting, direct beta-adrenergic inotropic agent used for inotropic support in patients with depressed cardiac contractility and function.[1]
  • Dobutamine is used off-label as a diagnostic agent during stress echocardiography for detecting coronary artery disease in patients who cannot use vasodilator stressors or participate in physical exercise.[2]

Safety

• • Premixed bags and vial strength may differ than our standard concentrations. Ensure proper dosing/rate of administration if non-standard concentration is used.

Alternative Agents & Management

• • For states of depressed cardiac contractility, use alternative catecholamine or non-catecholamine inotropes and vasopressors. Consider milrinone for low cardiac output conditions, including advanced HF, cardiogenic shock and postoperative states in patients with low LVEF.[3]
  • There is no alternative agent for dobutamine as a diagnostic agent. Utilize other diagnostic modalities for detecting coronary artery disease.[3]
  • Additional information can be found in a guidance document at: https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/02/12/42/What-You-Need-to-Know-Guidance-For-Clinicians-on-Dobutamine-Shortage

References

• 1. Dobutamine injection [prescribing information]. Lake Forest, IL: Hospira Inc. November 2019.
  2. Dobutamine. Lexicomp Online, Lexi-Drugs. UpToDate, Inc, Waltham, MA; 2023.
  3. Feature: What you need to know: Guidance for clinicians on dobutamine shortage. American College of Cardiology. August 2, 2022. Accessed January 11, 2024. https://www.acc.org/Latest-in-Cardiology/Articles/2022/08/02/12/42/What-You-Need-to-Know-Guidance-For-Clinicians-on-Dobutamine-Shortage. ¯¯