IV lorazepam shortage reported

Hospitals are reporting a shortage of injectable lorazepam, a core emergency drug for catatonia, with some resupply dates stretching into late 2026. (ashp.org) Lorazepam injection has been in shortage since 2021, according to psychiatrist Danae N. DiRocco, who told *Psychiatric Times* the problem worsened after one manufacturer stopped production and other suppliers were hit by higher demand. The magazine published its report on December 4, 2025. (psychiatrictimes.com) The American Society of Health-System Pharmacists updated its shortage bulletin on March 31, 2026. It listed Hikma back orders for several vial sizes, Pfizer supply as limited for 2 milligram per milliliter Carpuject syringes, and only two products as available: Fresenius Kabi 2 milligram per milliliter 1 milliliter vials and Hikma 2 milligram per milliliter 1 milliliter vials. (ashp.org) Catatonia is a syndrome in which a person can become mute, rigid, immobile, agitated, or unable to eat and drink. Consensus guidelines say first-line treatment is benzodiazepines such as lorazepam and, when that fails, electroconvulsive therapy. (pmc.ncbi.nlm.nih.gov ) (discovery.ucl.ac.uk) Injectable lorazepam matters in emergency departments because it can be given fast when a patient cannot swallow pills or needs a diagnostic “lorazepam challenge.” *Psychiatric Times* reported that clinicians have been forced to consider substitutes such as midazolam, which DiRocco said may require more frequent dosing. (psychiatrictimes.com) The shortage is not limited to psychiatry. The American Society of Health-System Pharmacists says lorazepam injection is also used for status epilepticus, preoperative anxiety, mechanical-ventilation sedation, acute delirium, and chemotherapy-related nausea and vomiting. (ashp.org) Federal regulators say drug shortages usually stem from manufacturing and quality problems, delays, discontinuations, recalls, or spikes in demand. The Food and Drug Administration says it works with manufacturers once a shortage is listed in its database and asks hospitals, pharmacists, and patients to report local supply disruptions. (fda.gov) The lorazepam bulletin names all of those pressures at once. Akorn ceased operations in February 2023, Amphastar and Hikma cited increased demand, and Pfizer cited manufacturing delays. (ashp.org) Lorazepam injection is officially labeled for status epilepticus and preanesthetic use, not catatonia, even though catatonia treatment is standard practice in psychiatry. The current shortage is hitting a use case that is common in hospitals but sits outside the drug’s formal label. (dailymed.nlm.nih.gov) (pmc.ncbi.nlm.nih.gov) For now, the shortage bulletin offers no clean end date. Hikma told the American Society of Health-System Pharmacists that some 10 milliliter products may not return until the fourth quarter of 2026, while some 1 milliliter 4 milligram per milliliter vials were projected for late April to early May 2026. (ashp.org)