Hospira, Pfizer's sterile injectables unit, is discontinuing cisatracurium besylate injection in both the 2 mg/mL and 10 mg/mL formulations. Supply runs out by late June 2026. The discontinuation was posted to the FDA database May 6. (Becker's Hospital Review, May 2026)
Cisatracurium is the neuromuscular blocking agent of choice in most ICUs, particularly for patients on mechanical ventilation and those at risk for acute respiratory distress syndrome. It is used daily in ORs across the country. Hospira has been one of the dominant suppliers.
The market is not clean. AuroMedics, one of the main generic alternatives, is already in shortage due to increased demand, which is a predictable consequence of a major supplier exiting. Fresenius Kabi, Meitheal Pharmaceuticals, and Somerset have supply available. AbbVie's branded Nimbex remains available at a significantly higher cost per vial. (ASHP Drug Shortage Database, May 2026)
Why it matters
This is a manufacturer exit from a low-margin generic category, not a temporary allocation issue. Hospira is not coming back on cisatracurium. The procurement question is not whether to act but how fast your GPO can confirm tier availability with a remaining supplier and whether your current contract covers the NDCs that are actually on the shelf.
The typical hospital response to a shortage is to wait for the pharmacy director to flag it. In this case, the OR cannot absorb a surprise. Cisatracurium is not a drug you substitute without a clinical review, and that review takes time your formulary committee may not have if you wait until late June to start.
Between the lines
AuroMedics going into shortage immediately after Hospira's announcement is the pattern worth tracking. When a major supplier exits, demand consolidates on the remaining generics faster than their production schedules can absorb. Fresenius Kabi and Meitheal are available today. That availability is not guaranteed in four weeks if every health system that relied on Hospira is now calling the same two companies.
Your window to lock in a confirmed order or adjust your GPO tier contract is now, not after the June shortage list updates.
By the numbers
Late June 2026: date Hospira supply runs out for both 2 mg/mL and 10 mg/mL cisatracurium formulations (FDA, May 6, 2026)
223: active drug shortages in the U.S. as of Q1 2026, second consecutive quarterly increase (ASHP, Q1 2026)
4+: remaining manufacturers with cisatracurium available as of May 2026: Fresenius Kabi, Meitheal, Somerset, AbbVie (Nimbex) (ASHP Drug Shortage Database, May 2026)
1: generic manufacturer (AuroMedics) already in shortage due to increased demand following Hospira's announcement (ASHP, May 2026)
What to do this week
Call your GPO rep today and confirm which cisatracurium NDCs are covered under your current tier and which manufacturers have confirmed supply. If AuroMedics is your contracted generic source, get an alternative on paper before June.