We are aware of shortages of multiple intravenous (IV) fluid products from all three Australian suppliers (Baxter Healthcare, B.Braun, and Fresenius Kabi).
IV fluids are essential medicines used in hospitals for routine and critical care. They are crucial for fluid replacement, resuscitation, and administering other medications directly into the bloodstream. The shortage is particularly affecting multiple bag sizes of Sodium Chloride 0.9% (saline) and Compound Sodium Lactate (Hartmann’s solution) products.
The shortages are due to multiple factors including global supply limitations, unexpected increases in demand, and manufacturing issues.
To improve supply, we have approved multiple overseas-registered alternative saline fluids under section 19A of the Therapeutic Goods Act 1989. We are continuing to prioritise evaluation of additional applications submitted under section 19A. Please see further information below or visit our Section 19A approvals database for up-to-date information about the alternative products (search by the active ingredient, ‘0.9% Sodium Chloride’).
We continue to collaborate with jurisdiction health departments, and suppliers of Australian-registered IV fluid products to monitor the situation and address any regulatory barriers to supply.
Suppliers have advised us that supply will continue to be constrained throughout 2024.
Information for health services
The TGA has been closely monitoring the IV fluid situation and discussing supply challenges with state and territory health department in our Medicines Availability Working Group (MAWG) meetings.
Managing the shortage and supply of IV fluids is a priority for us, as we understand these medicines are of critical importance.
To address the shortage, we have approved the importation and supply of the following substitute overseas-registered IV fluids under section 19A of the Therapeutic Goods Act 1989. State and territory health departments can contact the approval holders of relevant 19A products to arrange orders.
| S19A product | Approval holder |
| 0.9% Sodium Chloride Injection, USP in VIAFLEX bag 50mL, 100mL and 1000 mL (Baxter USA) | Baxter Healthcare Ph: 1800 229 837 |
| 0.9% Sodium Chloride Injection, USP in VIAFLO plastic container 1000mL (Baxter USA) | Baxter Healthcare Ph: 1800 229 837 |
| Sodium Chloride 0.9% Bioluz, Solution for Infusion in Dual Access PVC Bag 100mL and 1000 mL (France) | Aborns Pharmaceuticals Ph: 1300 117 772 |
| 0.9% Sodium Chloride Injection, USP in EXCEL bag 1000 mL (B. Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| Sodium Chloride 0.9% solution for infusion bag 100mL, 250mL, 500mL and 1000mL (Lavoisier, France) | Aborns Pharmaceuticals Ph: 1300 117 772 |
| 0.9% Sodium Chloride Injection, USP in EXCEL bag 250 mL, 500 mL, 1000 mL (B. Braun, USA) | Medsurge Healthcare Ph: 1300 788 261 |
| Lactated Ringer's Injection USP, sodium chloride, sodium lactate, potassium chloride, and calcium chloride solution 1000 mL bag (B.Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| 0.9% Sodium Chloride Injection, USP in E3 bag 1000mL (B, Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| 0.9% Sodium Chloride Injection, USP in EXCEL PLUS bag 1000mL (B. Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| 0.9% Sodium Chloride Intravenous Infusion B.P. 500mL and 1000mL bottles (B. Braun, Malaysia) | B Braun Australia Ph: 02 9629 0200 |
| 0.9% Sodium Chloride solution for infusion in COSINUS bag 1000mL (Carelide, France) | Reach Pharmaceuticals Ph: 0422 429 648 |
| Compound Sodium Lactate Intravenous Infusion B.P. (Hartmann‘s Solution) 500mL and 1000 mL Bottle (B. Braun, Malaysia) | B Braun Australia Ph: 02 9629 0200 |
| Sodium chloride 0.9% solution for infusion in FREEFLEX bag 1000mL (Fresenius Kabi, Netherlands) | Pro Pharmaceuticals Group Ph: 1300 077 674 |
The Australian Commission on Safety and Quality in Health Care (ACSQHC) have developed factsheets for health service organisations and consumers. These factsheets include information on conservation strategies, alternative treatment options, and best practices for ensuring effective patient care during the shortage.
IV fluids availability modelling
The TGA, in collaboration with the Medicine Availability Working Group (MAWG), has used data provided by sponsors to forecast future availability and identify any supply gaps of IV fluids.
Please note, the information below has been updated as we have undertaken further modelling.
Our modelling has found that there may be short supply gaps over the next 4 to 6 weeks for the following presentations:
- Smaller volume 100 mL sodium chloride (saline)
- Larger volume 1000 mL sodium chloride
- Larger volume 1000 mL Hartmann’s solution
However, other products, such as 500 mL saline and Hartmann’s solution, are predicted to remain available in this period.
The TGA has shared the outcomes of this modelling with suppliers of IV fluids and the National IV Fluid Response Group (see below) to develop recommendations and strategies to assist with managing supply during this period. Recommendations include:
- Using alternative volume presentations (250 and 500 mL saline and 500 mL Hartmann’s solution) as substitutes where clinically appropriate.
- Careful management of existing stock and the application of appropriate conservation measures for at-risk presentations
Overall supply of both sodium chloride and Hartman’s solutions is expected to improve from October.
The IV fluid supply modelling was conducted using the Dynamic Model of Medicine Availability (DMMA) developed by Department of Health and Aged Care. The model offers an overview of current and future medicine availability based on various assumptions and demand data. The outputs serve as early warning signals to identify potential supply gaps. However, modelling is limited to those IV fluid presentations where the TGA has received complete datasets.
Further modelling may be conducted in the future to assist in updating the current recommendations based on further changes in the supply situation.
National IV fluid Response Group
On 12 August 2024, a National IV Fluid Response Group, led by the Victorian Chief Medical Officer was formed to collaboratively address IV fluid supply issues across Australia. This group includes representatives from state and territory health departments, private hospitals, the Commonwealth, the Australian Medical Association (AMA), the Australian and New Zealand College of Anaesthetists (ANZCA) and the Australian Veterinary Association. The group meets weekly to coordinate a national response to IV fluid shortages. Key actions include:
- Partnering across governments and private hospitals to work with manufacturers and distributors to help address supply issues.
- Sharing demand and supply data to better understand the severity and duration of the shortage.
- Maintaining regular and consistent communications across all stakeholders.
- Creating a repository of clinical guidance on appropriate conservation strategies in collaboration with the Australian Commission on Safety and Quality in Health Care (ACSQHC).
The work of the Response Group complements our ongoing efforts to coordinate supply and availability of IV fluids, which has been ongoing since the supply disruptions commenced.
Information for consumers
If you, or someone you care for, is affected by the current IV fluid shortages, it’s important to consult your healthcare professional for guidance. Alternative IV fluids or treatment options may be provided to ensure you receive the necessary care.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) has released a factsheet for consumers addressing IV fluid shortages. The factsheet provides you, your family, and carers with essential information on understanding the IV fluid shortage and what to expect during the shortage.
General information
We work with pharmaceutical companies to communicate information about shortages of their medicines to health professionals and patients. However, we cannot compel companies to register, manufacture, or increase supply in Australia.
We will update this advice as needed.
This webpage on the TGA website was printed on 12 Sep 2024. Printed content may be out of date. For up-to-date information, always refer to the digital version: https://www.tga.gov.au/about-IV-fluids-shortages