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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. 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 into 2025.
Information for health services
The TGA has been closely monitoring the IV fluid situation and discussing supply challenges with state and territory health departments 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 50 mL, 100 mL and 1000 mL (Baxter USA) | Baxter Healthcare Ph: 1800 229 837 |
| 0.9% Sodium Chloride Injection, USP in VIAFLO plastic container 1000 mL (Baxter USA) | Baxter Healthcare Ph: 1800 229 837 |
| Sodium Chloride 0.9% Bioluz, Solution for Infusion in Dual Access PVC Bag 100 mL 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 100 mL, 250 mL, 500 mL and 1000 mL (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 1000 mL (B. Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| 0.9% Sodium Chloride Injection, USP in EXCEL PLUS bag 1000 mL (B. Braun, USA) | Phero Pharma Ph: 1800 720 020 |
| 0.9% Sodium Chloride Intravenous Infusion B.P. 500 mL and 1000 mL bottles (B. Braun, Malaysia) | B. Braun Australia Ph: 02 9629 0200 |
| 0.9% Sodium Chloride solution for infusion in COSINUS bag 1000 mL (Carelide, France) | Reach Pharmaceuticals Ph: 0422 429 648 |
| Compound Sodium Lactate Intravenous Infusion B.P. (Hartmann‘s Solution) 500 mL and 1000 mL Bottle (B. Braun, Malaysia) | B. Braun Australia Ph: 02 9629 0200 |
| Sodium chloride 0.9% solution for infusion in FREEFLEX bag 1000 mL (Fresenius Kabi, Netherlands) | Pro Pharmaceuticals Group Ph: 1300 077 674 |
| 0.9% sodium chloride IV infusion in VIAFLEX bag 50 mL, 100 mL and 500 mL (Baxter, Singapore) | Akesa Pty Ltd (03) 9088 6222 |
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 of IV fluids and to identify any supply gaps.
Please note, the information below has been updated after further modelling in November 2024.
Our updated modelling has found that supply of IV fluids remains limited, with sodium chloride (saline) presentations particularly affected. The supply of larger volume 1000 mL sodium chloride is expected to be especially vulnerable and will need careful management.
Supply of Hartmann’s solution (both the 500 mL and 1000 mL presentations) remains limited but is less constrained than the 1000 mL sodium chloride.
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. They have recommended:
- that careful management of existing stock and use of appropriate conservation measures for all presentations should continue
- consideration of ordering overseas-registered (section 19A) sodium chloride 1000 mL products to build safety buffers, as the supply of this presentation is particularly limited
- assessment of stockholdings of all presentations of sodium chloride, with health facilities to also consider building safety buffers using overseas-registered (section 19A) products for the smaller volumes if needed.
The IV fluid supply modelling was conducted using the Dynamic Model of Medicine Availability (DMMA) developed by the 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 of potential supply gaps. However, modelling is limited to those IV fluid presentations where the TGA has received complete datasets.
We may conduct further modelling in the future to assist in updating the current recommendations.
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 regularly 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 since the supply disruptions started.
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 about the IV fluid shortage and what to expect.
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.