About the cyclophosphamide and ifosfamide injection shortages

In early February 2026, pharmaceutical company Baxter Healthcare notified us of shortages of cyclophosphamide and ifosfamide injection products. 

These medicines are used to treat various types of cancer. Cyclophosphamide is also used to treat some diseases of the immune system, and to prevent rejection of organ transplants.

The global supply constraints are due to manufacturing issues and a subsequent increase in demand. The shortages started mid-March 2026 and are affecting the following medicines:

*Baxter Healthcare has told us that although the shortage of Endoxan 2 g powder for injection vial has been extended until 30 November 2026, they will continue to receive some supply during this period.

Up-to-date information about these shortages is also published on the Medicine shortage reports database, which can be searched by a medicine’s trade name (brand) or active ingredient. 

We have approved the supply of multiple overseas-registered cyclophosphamide and ifosfamide injection products in various strengths, shown in the tables below, under section 19A of the Therapeutic Goods Act 1989, to reduce the impact of these shortages. 

Go to the Section 19A approvals database for up-to-date information about these alternative products (search by the active ingredient).

Information for patients

We understand the importance of a reliable supply of these medicines for the patients who use them. We also appreciate the concern and frustration these shortages may cause. 

To help with supply, we have approved access to overseas-registered versions of cyclophosphamide and ifosfamide injection products. The healthcare professionals involved in your treatment can order these alternative products by calling the approval holders, whose contact details are available on the Section 19A approvals database. 

Information for healthcare professionals

We understand it can be difficult managing the impacts of these shortages and finding suitable alternative treatments.

We have approved the supply of multiple overseas-registered cyclophosphamide and ifosfamide injection products in various strengths (see the tables above). Contact the approval holder for details about ordering these products. More details are available on our Section 19A approvals database. 

Reconstitution and administration instructions may differ for overseas-registered cyclophosphamide and ifosfamide products. Refer to the corresponding overseas product information for instructions about reconstitution and administration. The ‘Dear Healthcare Professional Letter’ supplied with each order will outline significant differences between overseas-registered and Australian-registered products.

Prior to prescribing, healthcare professionals should determine if the overseas-registered product is suitable for the patient. 

Please note that these products are not currently subsidised on the Pharmaceutical Benefits Scheme (PBS). 

General information

As the dates given for these shortages may change, we encourage you to check the Medicine shortage reports database for updates about the supply of cyclophosphamide and ifosfamide injections.

Please also keep in mind that we can work with pharmaceutical companies to communicate information about medicine shortages to health professionals and patients, but we cannot compel companies to increase supply or apply to have their products subsidised on the PBS.

While we can suggest approaches to manage the supply of medicines during shortages, we do not have the power to regulate the clinical decisions of health professionals.

We will continue to monitor the supply of cyclophosphamide and ifosfamide injections and work with the suppliers and relevant health professionals to update this advice if needed. 

Reporting problems

Consumers and health professionals are encouraged to report problems with medicines or vaccines. Your report will contribute to the TGA's monitoring of these products.

The TGA cannot give advice about an individual's medical condition. You are strongly encouraged to talk with a health professional if you are concerned about a possible adverse event associated with a medicine or vaccine.