# Major Recall Alert: Shortage of Vasopressin Injection, USP, 20 units/mL in Canada – Critical Updates for Healthcare Professionals
Health Canada has issued an urgent safety alert regarding a **shortage of Vasopressin Injection, USP, 20 units/mL** for intramuscular (IM) and subcutaneous (SC) administration. This shortage creates significant risks for patients requiring vasopressin therapy in critical care settings. To address this issue, Health Canada has permitted the **temporary importation of US-authorized Vasopressin Injection, USP, 20 units/mL** (for intravenous [IV] infusion) from Fresenius Kabi USA, LLC, featuring English-only labels.
This development is vital for healthcare professionals, including emergency medicine physicians, critical care physicians, anesthesiologists, nurses, and pharmacists, who rely on Vasopressin therapy in life-threatening conditions.
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## Why This Recall is Important
Vasopressin is an essential medication commonly used to treat **postoperative abdominal distention, diabetes insipidus, and off-label cases like vasodilatory shock** in Canada. The shortage jeopardizes critical care patients, particularly those requiring vasopressin to maintain blood pressure during vasodilatory shock.
The **US-authorized Vasopressin Injection, USP (20 units/mL)** provides a temporary alternative for treatment; however, it is exclusively for **IV infusion after dilution** and is not suitable for IM or SC use. These significant differences demand immediate attention to avoid potential errors in administration.
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## Details of the Recall
Health Canada has approved the importation of the US-authorized Vasopressin to ensure patient care continuity during the shortage. Below are the key differences between the **US-authorized Vasopressin Injection** and the Canadian-authorized product:
- **Indications**:
- Canadian version: Authorized for IM/SC administration for postoperative abdominal distention, abdominal roentgenography, and diabetes insipidus.
- US version: Indicated for increasing blood pressure in adults with vasodilatory shock despite fluids and catecholamines.
- **Route of Administration**:
- Canadian version: IM or SC (no dilution required).
- US version: IV infusion **only** after mandatory dilution.
- **Packaging & Formulation**:
- Canadian version: Multi-use vial with a preservative.
- US version: Single-dose vial, preservative-free.
- **Dilution Requirements**:
- Canadian version: Ready to use.
- US version: Must be diluted to 0.1 or 1 unit/mL in normal saline or 5% dextrose.
- **Safety & Storage**:
- US product lacks a Drug Identification Number (DIN) and barcodes compatible with Canadian systems. Healthcare facilities must generate stickers for proper tracking.
For complete prescribing instructions and safety guidelines, professionals are encouraged to consult the **US Prescribing Information (USPI)** available on the Fresenius Kabi Canada Ltd. website.
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## What You Should Do
Healthcare professionals must stay vigilant and take the following actions:
- Recognize the key differences in **indication, route of administration, packaging, and preparation** between the Canadian and US-authorized Vasopressin products.
- Use the **US-authorized Vasopressin** exclusively for IV infusion after dilution. IM or SC administration is neither recommended nor safe.
- Visit the Fresenius Kabi Canada website to access the **USPI in English and French**.
- Ensure proper **label adherence** for the US product since it lacks a DIN and barcode for medication management systems in Canada.
- Report any **adverse reactions or unexpected events** to **Fresenius Kabi Canada Ltd.** or **Health Canada** through MedEffect Canada or by calling 1-866-234-2345.
Access more details from the official Health Canada safety alert here: [Health Canada Recall – Vasopressin](https://recalls-rappels.canada.ca/en/alert-recall/importation-us-authorized-vasopressin-injection-usp-20-unitsml-iv-infusion-due-current).
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