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Shortage: Sterile Water for Injection/Sodium Chloride Injection

March 16 , 2018


There is a national shortage of 10 mL and 20 mL vials of Sterile Water and Sodium Chloride 0.9% for Injection. 


Reserve sterile water for injection vials for those medications that can only be reconstituted with sterile water.

  • Refer to the AHS Provincial Parenteral Monographs for information on alternative sterile liquids for reconstitution
  • See Appendix for a list for medications that must be reconstituted with sterile water

When clinically appropriate, collaborate with prescribers to switch IV medications to oral formulations. Consult Pharmacy as needed.

The minibag stock has now stabilized.

Infection Prevention and Control has agreed that the use of minibags for single patient use is temporarily approved for reconstitution of medications during this shortage.

  • When appropriate, use a reconstitution device
  • When preparing IV direct medications, withdraw desired reconstitution  volume from minibag using aseptic technique.
  • Use one bag- for one patient- for one hour.
  • Label the minibag and discard used minibag after one hour.
  • Multiple accesses to a single use minibag increases the risk of contamination. Remember new needle, new syringe every time.

Prefilled Sodium Chloride 0.9% syringes must be used to flush vascular access devices only and must not be used for reconstituting medications. 

For medication reconstitution DO NOT SUBSTITUTE:

  • Sterile water for irrigation
  • Sterile water for inhalation
  • Sodium Chloride 0.9% for irrigation
  • Bacteriostatic water for injection

Note: The use of sterile water and normal saline products for wound care should be reviewed to identify alternate products and discontinue the use of sterile vials.

Medications that MUST be reconstituted ONLY with sterile water

 Refer to Provincial Parenteral Monographs for details

  • aldesleukin
  • amphotericin B
  • amphotericin B liposomal
  • ampicillin
  • anti-thymocyte globulin, RABBIT
  • asparaginase (KIDROLASE®)
  • azaTHIOprine
  • AZIthromycin
  • basiliximab
  • bivalirudin
  • ceFAZolin (1 gram vials only)
  • cefUROXime
  • cefTAZidime
  • cloxacillin
  • dantrolene
  • deferoxamine
  • digoxin Immune Fab
  • erythromycin
  • estrogens, conjugated
  • inFLIXimab (INFLECTRA brand only)
  • interferon alfa-2b
  • OLANZapine
  • pamidronate
  • pembrolizumab
  • pentamidine
  • piperacillin
  • pralidoxime
  • rasburicase
  • rifAMPin
  • streptomycin
  • vancomycin
  • voriconazole

 Provincial Monographs:

 Contact Information:


For further information, contact your site Pharmacy Department or as below,

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